Cancer services
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Enhancing Cancer Services: Addressing Overuse, Utilization, and Psychosocial Care
Overuse of Cancer Services
Overuse in Cancer Management
Overuse of health services in cancer care, where the harms outweigh the benefits, is a significant issue. A systematic review identified 59 articles measuring overuse of 154 services, primarily focusing on diagnostic imaging in low-risk prostate and breast cancer. The studies predominantly involved adult or geriatric patients in the US. Despite the attention to overuse, evidence remains limited, particularly regarding active cancer therapeutics and interventions aimed at reducing overuse.
Utilization of Health Services by Cancer Survivors
Patterns and Determinants of Health Service Utilization
Cancer survivors' utilization of health services varies significantly. Younger, white survivors are more likely to receive follow-up screening, preventive care, and professional mental health services, while hospitalization rates are lower. Disparities in service use are evident, influenced by factors such as ethnicity, socio-demographic status, and type of health insurance. Overall, follow-up care utilization is lower than expected, indicating barriers for certain groups of survivors.
Home Care Services for Cancer Survivors
Home care services are crucial for cancer survivors, yet accessibility barriers persist. A study of US cancer survivors found that only 10% received home care services, with significant sociodemographic variability. Factors such as higher age, female sex, lower income, unmarried status, public insurance, and comorbidities increased the likelihood of being eligible for home care. However, Hispanic ethnicity was associated with lower odds of receiving these services.
Integrating Psychosocial Care
Challenges in Psychosocial Care Integration
Despite evidence of significant psychosocial problems among cancer patients, many do not receive adequate care. The primary challenge is the lack of integrated psychosocial care systems within cancer centers. Effective integration requires a collaborative care model, involving systematic need identification, integrated care delivery by care managers, specialist supervision, and outcome-based care adjustments. Trials have shown this model to be feasible and effective, particularly for managing depression in cancer patients.
Mechanisms to Link Patients to Support Services
The uptake of psychosocial support services among cancer patients is low. Mechanisms to link patients to these services are less frequently considered. A systematic review highlighted the need for effective mechanisms to connect patients with psychosocial support, emphasizing the importance of addressing this gap to improve patient outcomes.
Improving Patient Experience and Satisfaction
Cancer Patient Service Experience
Patient service experience significantly impacts satisfaction. A study in Delhi, India, identified five dimensions of service experience: service environment, emotive, behavioral, comfort, and social experiences. These dimensions collectively influence patient satisfaction, underscoring the importance of a holistic approach to service delivery in cancer care.
Supporting Psychological Well-being
Patients' perceptions of cancer services' support for psychological well-being are crucial. Positive interactions with staff, other patients, and the hospital environment contribute to a sense of being in "safe hands," which supports well-being during treatment. This highlights the need for interventions that facilitate peer support and effective communication strategies.
Conclusion
Addressing overuse, improving service utilization, and integrating psychosocial care are critical for enhancing cancer services. Efforts should focus on reducing unnecessary services, ensuring equitable access to follow-up and home care, and providing comprehensive psychosocial support. By addressing these areas, we can improve the overall quality of cancer care and patient satisfaction.
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