老年人紧急癌症诊断:模式,子组和对医疗保健质量指标的影响
Sarah E Soppe1, Sharon Peacock Hinton1, Ellis C Dillon2
1Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
JNCI cancer spectrum
|January 29, 2026
概括
超过三分之一的老年人通过紧急呈现 (EP) 诊断出患有癌症,通常需要住院治疗. 农村地区的门诊EP可能会显示出可以避免的医疗保健接入障碍.
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:
- 紧急呈现 (EP) 癌症诊断与较差的生存率和医疗保健获取问题有关.
- EP反映了侵袭性疾病和有限的日常医疗保健参与.
- 这项研究调查了EP,区分住院和非住院病例,以确定护理障碍.
研究的目的:
- 描述老年人各种癌症类型的紧急情况 (EP).
- 为了比较住院和非住院EP的人口统计和临床特征.
- 为了确定可避免的障碍,及时治疗癌症的潜在指标.
主要方法:
- 对被诊断患有14种癌症类型的66岁以上患者的SEER-Medicare数据 (2008-2017年) 的分析.
- 使用线性回归的EP流行和特征的描述.
- 评估EP前的医疗保健利用模式.
主要成果:
- 38%的患者 (N=614,885) 患有EP诊断;其中80%需要住院治疗.
- EP患者更有可能获得诊断前的紧急护理,并且不太可能获得之前的非紧急症状护理.
- 门诊EP比住院EP更常见于年轻 (<70岁),非大都会和局部癌症患者.
结论:
- 超过三分之一的美国老年癌症患者是通过EP诊断出来的,其中大多数是住院治疗.
- 门诊EP,特别是在农村地区,癌症不那么晚期,可能表明重要的,可避免的护理障碍.
- 确定EP子组可以为改善及时癌症诊断和减少医疗保健差异的策略提供信息.
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