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Claims-based measures of care coordination and long-term health among older women with endometrial cancer

患有子宫内膜癌的老年妇女的基于索赔的护理协调和长期健康措施

基本信息

批准号：
10579456
负责人：
Hazel B Nichols
金额：
$ 7.78万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-01-19 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10579456
关键词：
Adherence Aftercare Breast Cancer survivor Cancer Detection Cancer Survivor Cancer Survivorship Cardiovascular Diagnostic Techniques Cardiovascular Diseases Cardiovascular system Caring Cause of Death Characteristics Chronic Colorectal Cancer Complex Data Data Sources Detection Development Disease Early Diagnosis Emergency department visit Endometrial Endometrial Carcinoma Ensure Failure Guidelines Gynecologic Gynecologic Oncologist Gynecologic Oncology Gynecologist Health Healthcare Histology Hospitalization Intervention Link Long-Term Survivors Malignant Neoplasms Malignant neoplasm of prostate Measures Medical Medicare Modeling Newly Diagnosed Obesity Oncologist Outcome Patient Care Patient-Focused Outcomes Patients Pattern Periodicals Physical Examination Physicians Population Prevention Preventive care Primary Care Physician Provider Quality of Care Recommendation Recording of previous events Recurrent Malignant Neoplasm Research Risk Risk Factors Role SEER Program Societies Specialist Subgroup Survivors Symptoms Testing Time Variant Visit Woman cancer diagnosis cancer recurrence cancer therapy cardiovascular disorder risk care coordination care fragmentation data resource demographics design follow-up health care delivery health care service high risk hospitalization rates improved novel older women poor health outcome prevent provider communication risk sharing side effect survivorship therapy development urban area

项目摘要

Abstract By the year 2030, the number of U.S. women with an endometrial cancer history is expected to exceed 1 million. The care needs of older endometrial survivors include not only regular follow-up visits for detection of cancer recurrence, but also the prevention and management of other non-cancer medical conditions. Cardiovascular disease (CVD) may be of especially critical concern, given the role of obesity as a shared risk factor for both endometrial cancer and CVD. Care for non-cancer conditions, as well as general preventive care and management of side effects of cancer treatment, is likely to require the involvement of primary care physicians or other specialists, in addition to the gynecologists and/or gynecologic oncologists who may perform the recommended follow-up exams for detection of endometrial cancer recurrence, but may not have the expertise to manage other medical conditions. The resulting complexity of healthcare needs for endometrial cancer survivors may lead to fragmentation of care, suboptimal care quality, and, ultimately, poorer health outcomes. Strategies to improve surveillance and management of CVD and other chronic conditions during survivorship, while also ensuring that women receive the recommended follow-up visits specific to their cancer history, are needed to support the complex health needs of endometrial cancer survivors. Care coordination refers to efforts to organize patient care activities between two or more providers involved in the patient’s care to facilitate the appropriate delivery of health care services. Measures of care coordination, which model shared patient networks by connecting physicians with common patients, have been developed using administrative claims data, and have been validated as a means of accurately representing provider communication patterns. We propose to utilize the Surveillance, Epidemiology, and End Results (SEER)- Medicare linked data resource to examine associations between claims-based measures of care coordination and long-term health outcomes after endometrial cancer. Specifically, we will assess whether higher degrees of care coordination during years 1-3 after endometrial cancer diagnosis are predictive of greater adherence to guideline-recommended follow-up for detection of endometrial cancer recurrence, lower risk of CVD diagnoses, lower risk of hospitalizations and emergency department visits, and higher overall survival. This research will inform the development of targeted interventions that seek to enhance the delivery of endometrial cancer survivorship care and improve patient outcomes.

摘要到2030年，有子宫内膜癌病史的美国妇女人数预计将超过1 万老年子宫内膜幸存者的护理需求不仅包括定期随访以检测子宫内膜癌，癌症复发，但也预防和管理其他非癌症的医疗条件。考虑到肥胖作为一种共同风险的作用，心血管疾病（CVD）可能是一个特别重要的问题子宫内膜癌和CVD的因素。对非癌症疾病的护理，以及一般预防癌症治疗副作用的护理和管理可能需要初级保健的参与医生或其他专家，除了妇科医生和/或妇科肿瘤学家，进行推荐的随访检查以检测子宫内膜癌复发，但可能没有管理其他医疗条件的专业知识。由此产生的医疗保健需求的复杂性子宫内膜癌幸存者可能导致护理的分散、次优的护理质量，并且，最终，健康状况较差。改善心血管疾病和其他慢性在确保妇女接受建议的后续访问的同时，具体到他们的癌症史，需要支持子宫内膜癌的复杂的健康需求，幸存者护理协调是指在两个或两个以上参与的提供者之间组织患者护理活动的努力，病人的护理，以促进适当的医疗保健服务的提供。护理协调措施，通过将医生与普通患者联系起来，使用行政索赔数据，并已被验证为准确代表供应商的一种手段，交流模式我们建议利用监测、流行病学和最终结果（SEER）- 医疗保险链接数据资源，以检查基于索赔的护理协调措施之间的关联以及子宫内膜癌后的长期健康结果。具体而言，我们将评估是否更高的学位子宫内膜癌诊断后1-3年的护理协调可以预测更大的依从性，指南推荐的随访检测子宫内膜癌复发，降低CVD风险诊断，降低住院和急诊的风险，提高总生存率。这研究将为寻求提高子宫内膜异位症的发生率的有针对性的干预措施的发展提供信息。癌症生存护理和改善患者的结果。