第二阶段/第三阶段直肠癌治疗后监测护理模式:一个SEER-医疗保险研究
Catherine Chioreso1, Mary C Schroeder2, Irena Gribovskaja Rupp3
1Department of Epidemiology, University of Iowa College of Public Health, USA.
对直肠癌的治疗后监测不足,特别是在老年患者中. 年轻的年龄和化学辐射治疗与增加的监测有关,强调需要针对性策略来改善后续护理.
科学领域:
- 在瘤学瘤学.
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 结直肠癌复发率需要有效的治疗后监测.
- 使用模式和影响监控因素尚未得到充分了解.
研究的目的:
- 估计对直肠癌的治疗后监测的利用率.
- 确定与监督遵守相关的因素.
主要方法:
- 对1024名SEER-Medicare患者II/III期直肠癌 (2007-2013) 的回顾性分析.
- 后勤回归用于确定与结肠镜检查,医生访问,CEA测试和CT扫描相关的因素,在治疗后14个月内进行.
主要成果:
- 监测率:≥1次结肠镜 (55%),≥2次医生访问 (54%),≥2次CEA测试 (47%),≥2次CT (20%).
- 年龄较小和化疗辐射与所有监测类型有关.
- 婚姻状况,医院的数量,性别,种族和外科医生的数量都影响了特定的监测方式.
结论:
- 对直肠癌的治疗后监测是不理想的.
- 年轻的患者和接受化学辐射治疗的患者表现出更高的坚持.
- 需要多元组件策略来加强监测,考虑患者和提供者因素.
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