在认证医院和非认证医院的初始癌症治疗
Jochen Schmitt1, Monika Klinkhammer-Schalke, Veronika Bierbaum
1Center for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden; Tumorzentrum Regensburg Institut für Qualitätssicherung und Versorgungsforschung, Universität Regensburg; AOK Research Institute, Berlin; Association of German Tumor Centers, Berlin.
Deutsches Arzteblatt international
|August 16, 2023
概括
在经过认证的医院进行的初始癌症治疗可以改善患者的整体存活率. 尽管有指导方针,但许多人仍然在未经认证的中心接受护理,错过了潜在的生存益处.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 德国国家癌症计划要求提供高质量的,基于证据的癌症护理.
- 癌症中心的认证计划存在,但缺乏全面的评估.
- 确保癌症患者的最佳结果需要评估认证护理的影响.
研究的目的:
- 评估在认证医院的初始癌症治疗是否会影响整体存活率.
- 为了比较各种癌症类型的认证和非认证治疗中心之间的结果.
- 为德国有关癌症护理的政策提供信息.
主要方法:
- 在WiZen项目中的受控队列研究.
- 成年AOK保险人的全国数据 (2009-2017).
- 对患有结肠,直肠,肺,胰腺,乳腺,宫,前列腺,子宫内膜,卵巢,头部和神经瘤癌症的患者的整体存活率的分析.
主要成果:
- 在经过认证的医院进行初始治疗与所有研究的癌症实体的整体存活率的改善有关.
- 死亡风险比 (HR) 从0.97 (肺癌) 到0.77 (乳腺癌) 之间.
- 总生存时间的绝对风险降低从0.62个月 (肺癌) 到4.61个月 (宫癌) 不同.
结论:
- 在经过认证的中心进行初始癌症治疗与降低死亡率有关.
- 超过40%的癌症患者在未经认证的医院接受初级护理,这与国家建议相反.
- 优先考虑认证的医院护理可以提高患者的生存率.
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