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Disponibilidad e integración de los cuidados paliativos en los centros de cáncer de los Estados Unidos
David Hui1, Ahmed Elsayem, Maxine De la Cruz
1Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
JAMA
|March 18, 2010
Resumen
La mayoría de los centros de cáncer ofrecen servicios de cuidados paliativos, pero la integración varía. Los centros del Instituto Nacional del Cáncer tienen programas de cuidados paliativos más desarrollados que los centros no pertenecientes al NCI.
Área de la Ciencia:
- Oncología Oncología.
- Los cuidados paliativos son cuidados paliativos.
- Servicios de salud Servicios de salud Investigación Investigación.
Sus antecedentes:
- El panorama actual de los cuidados paliativos dentro de los centros de cáncer de EE.UU. sigue siendo en gran medida no caracterizado.
- Comprender la disponibilidad de cuidados paliativos es crucial para mejorar el apoyo a los pacientes con cáncer.
Objetivo del estudio:
- Evaluar la disponibilidad e integración de los servicios de cuidados paliativos en los centros de cáncer de los Estados Unidos.
- Para comparar los servicios de cuidados paliativos entre los centros de cáncer designados por el Instituto Nacional del Cáncer (NCI) y los no NCI.
Principales métodos:
- Se realizó una encuesta entre junio y octubre de 2009, dirigida a ejecutivos y líderes de cuidados paliativos en centros de cáncer del NCI y no NCI.
- Se desarrollaron instrumentos de encuesta basados en revisiones de literatura, directrices del Foro Nacional de Calidad y aportaciones de médicos expertos.
- La disponibilidad de cuidados paliativos se definió por la presencia de al menos un médico de cuidados paliativos.
Principales resultados:
- Los centros de cáncer del Instituto Nacional del Cáncer demostraron tasas significativamente más altas de programas de cuidados paliativos, médicos, equipos de consulta de pacientes hospitalizados y clínicas ambulatorias en comparación con los centros no NCI.
- Las camas de cuidados paliativos dedicados y los hospicios operados por la institución fueron poco comunes en todos los centros encuestados.
- Si bien la mayoría de los centros informaron programas de cuidados paliativos, el alcance de los servicios y los niveles de integración variaron considerablemente.
Conclusiones:
- La mayoría de los centros de cáncer han establecido programas de cuidados paliativos, sin embargo, existen diferencias significativas en el alcance del servicio y la integración.
- Los centros designados por NCI generalmente ofrecen servicios de cuidados paliativos más completos que sus contrapartes no NCI.
- Se necesitan más esfuerzos para mejorar la integración y estandarización de los cuidados paliativos en todos los centros de cáncer.
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