区域合作与甲状腺癌临床管理的趋势
Sam P J van Dijk1, Hannelore I Coerts1, Ivona Lončar1
1Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
概括
荷兰的一个区域瘤网络导致了甲状腺癌治疗的降级和复杂病例的集中. 然而,没有观察到术后并发症的显著变化,这突显了评估网络对护理质量影响的挑战.
科学领域:
- 在瘤学瘤学.
- 手术管理的手术管理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 分析了荷兰西南部的甲状腺癌管理趋势和临床结果.
- 一个区域合作网络于2016年1月实施,影响了护理的提供.
- 了解这些网络对患者治疗结果的影响至关重要.
研究的目的:
- 检查甲状腺癌管理的趋势和在建立区域瘤网络之前和之后的临床结果.
- 评估网络对手术管理,集中和等待时间的影响.
- 为了评估网络内的甲状腺癌患者的术后并发症率.
主要方法:
- 在2010年1月至2021年6月期间诊断出的1186名甲状腺癌患者的回顾性队列研究.
- 从荷兰西南部地区的10家合作医院收集的数据.
- 主要结局:术后并发症;次要结局:手术管理趋势,集中和等待时间.
主要成果:
- 随着时间的推移,没有观察到术后并发症 (甲状腺功能低下,神经衰竭,重新手术) 的显著差异.
- 较低风险的乳头甲状腺癌转诊到学术医院的情况有所减少 (85%至62%).
- 仅仅甲状腺切除术手术的增加从9%上升到20%.
结论:
- 区域瘤网络与复杂病例的治疗降级和集中相关.
- 尽管管理方式发生了变化,但术后并发症率保持稳定.
- 如果没有统一的质量指标,很难评估区域网络对护理质量的影响.
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