患者导航对脆弱人群肺癌查完成的影响
Sheena Bhalla1,2,3, Vijaya Natchimuthu3, Jessica L Lee4
11Division of Hematology-Oncology, UT Southwestern Medical Center, Dallas, TX.
Journal of the National Comprehensive Cancer Network : JNCCN
|March 15, 2024
概括
电话导航没有改善初始肺癌查 (LCS) 的完成. 然而,导航增加了订购的LCS步骤的完成率,这表明改进的流程和教育是安全网卫生系统的关键.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 在瘤学瘤学.
背景情况:
- 低剂量的基于CT的肺癌查 (LCS) 降低了高风险个体的死亡率.
- 查过程可能是复杂的,特别是对于服务不足的少数群体.
- 安全网卫生系统在实施LCS时面临着独特的挑战.
研究的目的:
- 评估基于电话的导航对LCS的有效性.
- 在安全网医疗保健环境中评估LCS完成率.
- 找出阻碍LCS完成的障碍.
主要方法:
- 随机对照试验,将导航与LCS的通常护理进行比较.
- 参与者是德克萨斯州达拉斯的帕克兰健康的合格患者.
- 主要终点是完成前3个连续的LCS步骤.
主要成果:
- 在导航和通常护理组之间完成前3个LCS步骤没有显著差异 (12%对9%,P=.30).
- 在导航组中,有序的LCS步骤的完成率更高 (86%对79%,P=.03).
- 缺乏订单是未完成的主要原因.
结论:
- 仅仅是电话导航并没有显著改善最初的LCS完成.
- 导航改善了订单完成后的完成,突出了过程的重要性.
- 通过临床教育和EHR增强来改善订单的放置,以及导航,可能会促进安全网系统中的LCS.
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