SAN JUAN MB COMMUNITY CLINICAL ONCOLOGY PROGRAM

在过去的几十年里，波多黎各的癌症统计数据稳步上升。预计到世纪之交，新增癌症病例将接近9000例。不幸的是，岛上的医疗保健服务系统并没有跟上这一趋势。其结果是宫颈、子宫内膜和烟草相关恶性肿瘤的高发病率。同样重要的是，肺癌、肝癌、胃癌、头颈部、食道和其他部位的癌症死亡率更高。在2000年的人口普查中，波多黎各岛的人口预计为391万。近200万人被认为没有医疗保险和贫困。几十年来，波多黎各州和市政府是该岛卫生服务的最大直接护理提供者。保健服务是利用全岛各地的初级、二级、三级和高级机构系统提供的。在战略位置优越的机构和大型医疗中心的大学医院提供继发性癌症治疗。在过去的6年里，PR政府开始了一场以健康维护组织（HMO）系统为基础的革命性医疗改革。圣胡安MBCCOP的目标是在不断变化的社区医疗环境中扩大和加强高质量的癌症控制和治疗研究；提供最先进的癌症控制和治疗；向全岛各地的保健提供者提供教育和宣传活动；评估在这种情况下MBCCOP绩效的选定问题。圣胡安MBCCOP位于公共关系医疗中心的圣胡安市立医院。其他主要参与机构是圣胡安退伍军人医院和圣胡安肿瘤医院。主要附属机构是PR GI研究所和Hato Rey血液学/肿瘤学协会。这些机构每年总共照顾2000多名新的癌症患者。

Puerto Rico has shown a steady increase in cancer statistics during the past decades. It is expected to reach close to 9,000 new cancer cases by the turn of the century. Unfortunately, the health care delivery system is the island has not matched that trend. The result is a high incidence of cervical, endometrial and tobacco-related malignancies. Equally important the cancer death rate is higher from lung, liver, stomach, head and neck, esophagus and other sites. For the year 2000 population census, the Island of Puerto Rico is expected to show a population of 3.91 million. Close to 2.0 million are considered to be medically uninsured and indigent. For decades the PR state and municipal government were the largest direct care providers of health services in the island. Health care was provided utilizing a system of primary, secondary, tertiary and supratertiary institutions throughout the island. Supratertiary cancer care was given at strategically placed institutions and university hospitals in large medical centers. During the past 6 years, the government of PR began a revolutionary health care reform that based health care on a health maintenance organization (HMO) system. The goals of the San Juan MBCCOP are to expand and strengthen quality cancer control and treatment research in a changing medical environment in the community; to provide access to state-of-the-art cancer control and treatments; to provide educational and informational activities to health care providers throughout the island; to evaluate selected issues of the MBCCOP performance in this setting. The San Juan MBCCOP is located at the San Juan City Municipal Hospital in the PR Medical Center. The other main participating institutions are the San Juan Veterans Hospital and the San Juan Oncologic Hospital. The major affiliates are the PR GI Institute and the Hato Rey Hematology/Oncology Associates. Together, these institutions care for more than 2,000 new cancer patients per year.