米国がんセンターにおける緩和医療の利用可能性と統合
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
まとめ
ほとんどのがんセンターは緩和ケアサービスを提供していますが,統合は異なります. 国立がん研究所 (NCI) のセンターは,NCI以外のセンターよりも,緩和ケアプログラムがより発達しています.
科学分野:
- 腫瘍学 腫瘍学
- 緩和ケアとは,緩和ケアです.
- 医療サービス 研究 医療サービス
背景:
- 現在,米国のがんセンター内の緩和医療の現状は,ほとんど特徴づけられていないままです.
- 緩和医療の可用性を理解することは,がん患者のサポートを改善するために不可欠です.
研究 の 目的:
- 米国がんセンターにおける緩和ケアサービスの可用性と統合を評価する.
- 国立がん研究所 (NCI) に指定されたがんセンターとNCI以外のがんセンターの緩和ケアサービスを比較する.
主な方法:
- 2009年6月から10月にかけて,NCIおよびNCI以外のがんセンターの幹部および緩和ケアリーダーを対象に調査が行われました.
- 調査の道具は,文献レビュー,国家品質フォーラムのガイドライン,専門医の意見に基づいて開発されました.
- 緩和医療の可用性は,少なくとも1人の緩和医療医師の存在によって定義されました.
主要な成果:
- 国立がん研究所 (NCI) がんセンターは,非NCIセンターと比較して,緩和ケアプログラム,医師,入院相談チーム,外来診療所の割合が著しく高かったことを実証しました.
- 専用の緩和ケアベッドと機関運営のホスピスは,調査対象のすべてのセンターでは珍しかった.
- ほとんどのセンターでは緩和ケアプログラムが報告されているが,サービスの範囲と統合レベルはかなり異なっていた.
結論:
- 大多数のがんセンターは緩和ケアプログラムを確立しているが,サービス範囲と統合において大きな格差がある.
- NCIに指定されたセンターは,一般に,NCI以外のセンターよりもより包括的な緩和ケアサービスを提供しています.
- すべてのがんセンターにおける緩和医療の統合と標準化を強化するために,さらなる努力が必要である.
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