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Non-oncology physician visits after diagnosis of cancer in children
Marianne J Heins1, Maria F Lorenzi2, Joke C Korevaar3
1Netherlands Institute for Health Services Research (NIVEL), P.O Box 1568, 3500 BN, Utrecht, The Netherlands. m.heins@nivel.nl.
Insights
Family physicians and non-cancer specialists are highly involved in pediatric cancer care post-diagnosis, managing various health issues. Effective communication among all healthcare providers is crucial for optimal patient outcomes.
Area of Science:
- Pediatric Oncology
- Health Services Research
- Family Medicine
Background:
- Children with cancer need extensive medical, psychosocial, and educational support.
- The role of family physicians and non-cancer specialists in pediatric cancer care is understudied.
- Understanding non-oncology physician involvement offers insights into comprehensive healthcare delivery.
Purpose of the Study:
- To investigate the involvement of family physicians and non-cancer specialists in the care of children diagnosed with cancer.
- To analyze the frequency and reasons for non-oncology physician visits in the 5 years following diagnosis.
Main Methods:
- A cohort of 757 children diagnosed with cancer (under 15) was identified from a Canadian provincial registry (1991-2001).
- Each patient was matched with 10 controls of the same birth year and sex.
- Provincial health insurance data tracked family physician and non-cancer specialist visits for 5 years post-diagnosis/inclusion.
Main Results:
- Nearly all pediatric cancer patients saw both family physicians and non-cancer specialists in the first year post-diagnosis.
- After 5 years, 85% of patients still visited family physicians and 76% saw non-cancer specialists, significantly more than controls.
- Visits in the first year often involved neoplasms, lab test discussions, general symptoms (family physicians), and nervous system issues/treatment complications (non-cancer specialists).
Conclusions:
- Family physicians and non-cancer specialists play a significant role in pediatric cancer care during the initial years after diagnosis.
- Their involvement extends to managing cancer-related health problems and treatment complications.
- Enhanced communication among all healthcare providers is essential for integrated pediatric cancer care.
Background:
Children diagnosed with cancer often require extensive care for medical, psychosocial and educational problems during and after therapy. Part of this care is provided by family physicians and non-cancer specialists, but their involvement in the first years after diagnosis has barely been studied. Studying non-oncology physician visits may provide insight into the roles of different health care providers.
Methods:
We included 757 children diagnosed with cancer under age 15 between 1991 and 2001 from a Canadian provincial registry, and matched each to 10 controls of the same birth year and sex. We determined the number of family physician and non-cancer specialist visits in the 5 years after diagnosis (for patients) or inclusion (for controls) using data from the provincial health insurance plan.
Results:
In the first year after diagnosis, almost all patients visited both a family physician and non-cancer specialist. Although after 5 years percentages decreased to 85 and 76 %, respectively, these were still significantly higher than in controls. In the first year after diagnosis, both family physicians and non-cancer specialists were often consulted for neoplasms (62 and 90 %, respectively) and to discuss results of lab tests. In addition, family physicians were often consulted for general symptoms and non-cancer specialists for nervous system problems and complications of medical care.
Conclusions:
Family physicians and non-cancer specialists are highly involved in the care for children with cancer in the first years after diagnosis, including for health problems related to cancer or its treatment. This necessitates good communication among all physicians.
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