CANCER PATIENTS HOME CARE NEEDS AND COSTS

接受治疗的癌症患者的发病率不断上升， 医疗“非住院化”的趋势将导致更多的 在保护性环境之外接受护理的人 医院 患者如何受到这种趋势的影响，以及如何 社区支持系统满足了这些需求， 患者是当前和未来的重要问题。 由于患者的需求， 无法满足其日常生活和治疗相关需求 独立地。 拟议项目的总体目标是 描述和分析家庭护理的需求和服务， 复发或转移性癌症患者， 在三种不同的情况下开始化疗或放疗 美国东北部地区。 患者接受 治疗在农村（宾夕法尼亚州中部）和城市（纽约 城市）和全州（罗得岛）设置将进行评估。 在纵向访谈、服务跟踪、 以及电话生成的服务日志数据收集工作， 将描述患者的需求及其相关因素。 此外，本发明还提供了一种方法， 我们将描述患者（N=650）需求在 治疗后6个月启动期试验的过程 病人需求的增加是否反映在 所提供服务的水平和强度;测试 患者需求的决定因素，护理的充分性，以及 正式机构服务;描述情绪和 家庭（N=650）的社会经济负担， 如何照顾病人和负担的患病率和强度 与疾病进展和抗肿瘤相关的变化 治疗;并测试患者和 护理者负担使患者面临护理不足的风险， 这种关系是否通过引入正式的 家庭护理服务。 研究结果的政策影响将 根据目前的公共和私人保险进行审查 家庭护理服务的报销，特别提到 癌症患者最需要的服务类型 患者人群。

The increasing prevalence of cancer patients under treatment and the trend toward "dehospitalization" of care will lead to more people receiving care outside of the protective environment of the hospital. How patients are affected by this trend and how well the community support system meets the demands of these patients is an important issue for the present and the future. Demands (needs) for assistance at home arise due to patients' inability to meet their daily living and treatment-related needs independently. The overall goal of the proposed project is to describe and analyze the home care needs and services used by cancer patients with recurrent or metastatic cancer who are initiating chemotherapy or radiation therapy in three different areas of the Northeastern United States. Patients receiving treatment in a rural (Central Pennsylvania) an urban (New York City) and statewide (Rhode Island) setting will be assessed. Within the context of a longitudinal interview, service tracking, and telephone generated service diary data collection effort, patients' needs and their correlates will be described. In addition, we will; describe changes in patients (N=650) needs over the course of the six month post-treatment initiation period test whether increases in patients' needs are mirrored in increases in the level and intensity of services provided; test a model of the determinants of patients' needs, adequacy of care, and the use of formal agency services; describe the extent of emotional and socio-economic burden experienced by families (N=650) providing care to patients and how the prevelence and intensity of burden changes in relation to progression of disease and anti-tumor treatment; and test the extent to which levels of patient and caregiver burden place patients at risk of inadequate care and whether this relationship is modified by the introduction of formal home care services. The policy implications of study findings will be examined in the light of current public and private insurance reimbursement for home care services with specific reference to those types of services that are most needed by the cancer patient population.