在安全网环境中对肺癌查的系统性挑战:护理和信息技术碎片化
Haley I Tupper1, Florence X Doo2, Yannan Lin3
1General Surgery Resident, Division of General Surgery, Department of Surgery, University of California, Los Angeles, Los Angeles, California; Board Member, California Lung Cancer Coalition and the Society of Thoracic Surgeons Council on Health Policy; Program Manager, Los Angeles County Lung Cancer Coalition; Member, National Lung Cancer Roundtable State-Based Initiatives Workgroup and the California Dialogue on Cancer's Lung Cancer Screening and Health Equity Workgroups; Advisor, California State Cancer Plan 2026-2035 and American Lung Cancer Screening Initiative.
护理和健康信息的系统碎片化阻碍了安全网设置中的肺癌查. 这些挑战需要全面,公平的解决方案,超越个人组织,以提高风险人群的查率.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
- 癌症查计划 癌症查计划
背景情况:
- 在符合条件的美国人中,肺癌查率仍然很低 (<20%),尽管肺癌是癌症死亡的主要原因.
- 低收入和医疗补助保险人口面临最大的肺癌风险,但查率最低.
- 了解安全网环境中的系统性挑战对于改善肺癌查和护理提供至关重要.
研究的目的:
- 调查安全网组织中的系统性挑战,这些挑战会影响基于成像的癌症查护理的完整阶段.
- 确定在资源有限的环境中从查到治疗的多学科护理协调的障碍.
主要方法:
- 采用了定性案例研究设计,重点关注洛杉矶县有意抽样的安全网组织.
- 与查专家进行了半结构化的电话采访,以探索他们组织的基于图像的查管道.
- 诱导性主题分析用于分析转录的采访数据.
主要成果:
- 确定了两个主要的系统性挑战:跨组织的护理碎片化和孤立的健康信息,特别是成像数据.
- 这些挑战阻止了流程的简化和自动化,导致了人工,劳动密集型的解决方案.
- 碎片化影响了既有查计划,而不仅仅是新的查计划.
结论:
- 护理和健康信息技术的碎片化大大耗尽了安全网的资源,使得癌症查计划劳动密集.
- 有效,公平的选解决方案必须全面解决这些系统性问题,并超越个人组织边界.
- 解决这些障碍对于改善癌症查公平性和弱势群体的结果至关重要.
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