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06.07.2017 | Original Article | Ausgabe 4/2017

Annals of Behavioral Medicine 4/2017

Cancer Care Coordination: a Systematic Review and Meta-Analysis of Over 30 Years of Empirical Studies

Zeitschrift:
Annals of Behavioral Medicine > Ausgabe 4/2017
Autoren:
PhD Sherri Sheinfeld Gorin, MD, MAS David Haggstrom, MD, MA, MPH Paul K. J. Han, MD Kathleen M. Fairfield, PhD Paul Krebs, PhD Steven B. Clauser
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s12160-017-9876-2) contains supplementary material, which is available to authorized users.

Abstract

Background

According to a landmark study by the Institute of Medicine, patients with cancer often receive poorly coordinated care in multiple settings from many providers. Lack of coordination is associated with poor symptom control, medical errors, and higher costs.

Purpose

The aims of this systematic review and meta-analysis were to (1) synthesize the findings of studies addressing cancer care coordination, (2) describe study outcomes across the cancer continuum, and (3) obtain a quantitative estimate of the effect of interventions in cancer care coordination on service system processes and patient health outcomes.

Methods

Of 1241 abstracts identified through MEDLINE, EMBASE, CINAHL, and the Cochrane Library, 52 studies met the inclusion criteria. Each study had US or Canadian participants, comparison or control groups, measures, times, samples, and/or interventions. Two researchers independently applied a standardized search strategy, coding scheme, and online coding program to each study. Eleven studies met the additional criteria for the meta-analysis; a random effects estimation model was used for data analysis.

Results

Cancer care coordination approaches led to improvements in 81 % of outcomes, including screening, measures of patient experience with care, and quality of end-of-life care. Across the continuum of cancer care, patient navigation was the most frequent care coordination intervention, followed by home telehealth; nurse case management was third in frequency. The meta-analysis of a subset of the reviewed studies showed that the odds of appropriate health care utilization in cancer care coordination interventions were almost twice (OR = 1.9, 95 % CI = 1.5–3.5) that of comparison interventions.

Conclusions

This review offers promising findings on the impact of cancer care coordination on increasing value and reducing healthcare costs in the USA.

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Zusatzmaterial
Appendix Table A1 (DOCX 20.7 kb)
12160_2017_9876_MOESM1_ESM.docx
Appendix Table A2 (XLSX 29.2 kb)
12160_2017_9876_MOESM2_ESM.xlsx
Appendix Table A3 (DOCX 51.9 kb)
12160_2017_9876_MOESM3_ESM.docx
Appendix Table A4 (DOCX 58.2 kb)
12160_2017_9876_MOESM4_ESM.docx
Appendix Table A5 (XLSX 898 kb)
12160_2017_9876_MOESM5_ESM.xlsx
Literatur
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