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文献精选 > 近年高分"肿瘤微环境"研究（IF≥30，近5年）

Planning for post-pandemic cancer care delivery: Recovery or opportunity for redesign? ​

文献信息 ​

DOI10.3322/caac.21644
PMID32997807
期刊CA: a cancer journal for clinicians
影响因子232.4
JCR 分区Q1
发表年份2021
被引次数10
关键词癌症护理服务，2019年冠状病毒病（COVID-19），医疗服务交付，流行病
文献类型Journal Article
ISSN0007-9235
页码34-46
期号71(1)
作者Pelin Cinar, Richard Bold, Bryn A Bosslet, Daniela A Bota, Debra Burgess, Helen K Chew, Joshua G Cohen, Emad Elquza, Kathryn A Gold, Emi Kamiya, Beth Y Karlan, Rana R McKay, Sandip P Patel, Kimberly Ternavan, Jeanna Welborn, Maki Yamamoto, Hope S Rugo

一句话小结 ​

本研究回顾了加州大学癌症联盟在COVID-19大流行期间的应对与恢复规划，强调了在疫情初期不同地区对肿瘤患者管理建议的差异以及加州癌症护理服务模式的重塑机会。作者认为，这些经验将为未来癌症护理服务的提升提供重要指导。

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癌症护理服务 · 2019年冠状病毒病（COVID-19） · 医疗服务交付 · 流行病

摘要 ​

癌症护理的提供从未像在2019冠状病毒病（COVID-19）大流行期间那样迅速而剧烈地改变。大流行初期，各专业协会和政府机构发布的肿瘤患者管理建议未能考虑疫情影响的显著区域差异。加利福尼亚最初经历的病例数量低于预期，卫生保健系统并没有承受与其他地区相同程度的负担。鉴于加利福尼亚州COVID-19感染和死亡率的积极趋势，到2020年4月底，关于逐步恢复全面癌症服务的讨论开始启动。然而，到2020年7月，全国范围内，包括加利福尼亚在内的病例激增。本文回顾了加州大学癌症联盟在应对与恢复规划方面的经验，旨在为肿瘤学实践提供指导。加州大学癌症联盟成立于2017年，旨在汇聚五个加州大学综合癌症中心：加州大学戴维斯分校综合癌症中心、加州大学洛杉矶分校琼森综合癌症中心、加州大学欧文分校赵家综合癌症中心、加州大学圣地亚哥分校穆尔癌症中心，以及加州大学旧金山分校海伦·迪勒家庭综合癌症中心。文章重点介绍了这些癌症中心实施的干预措施，并着重讨论了护理服务模式重塑的机会。作者提出，他们在此次大流行中获得的经验将提升疫情前的癌症护理服务。

英文摘要 ​

The delivery of cancer care has never changed as rapidly and dramatically as we have seen with the coronavirus disease 2019 (COVID-19) pandemic. During the early phase of the pandemic, recommendations for the management of oncology patients issued by various professional societies and government agencies did not recognize the significant regional differences in the impact of the pandemic. California initially experienced lower than expected numbers of cases, and the health care system did not experience the same degree of the burden that had been the case in other parts of the country. In light of promising trends in COVID-19 infections and mortality in California, by late April 2020, discussions were initiated for a phased recovery of full-scale cancer services. However, by July 2020, a surge of cases was reported across the nation, including in California. In this review, the authors share the response and recovery planning experience of the University of California (UC) Cancer Consortium in an effort to provide guidance to oncology practices. The UC Cancer Consortium was established in 2017 to bring together 5 UC Comprehensive Cancer Centers: UC Davis Comprehensive Cancer Center, UC Los Angeles Jonsson Comprehensive Cancer Center, UC Irvine Chao Family Comprehensive Cancer Center, UC San Diego Moores Cancer Center, and the UC San Francisco Helen Diller Family Comprehensive Cancer Center. The interventions implemented in each of these cancer centers are highlighted, with a focus on opportunities for a redesign in care delivery models. The authors propose that their experiences gained during this pandemic will enhance pre-pandemic cancer care delivery.

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主要研究问题 ​

  1. 在后疫情时代，癌症护理交付模式重设计的具体机会有哪些？
  2. 如何评估在COVID-19大流行期间实施的癌症护理干预措施的有效性？
  3. 不同地区在癌症护理交付中的经验教训如何影响未来的政策制定？
  4. 针对不同类型癌症患者，后疫情时代的护理优先级应如何调整？
  5. UC癌症联盟在重启癌症服务时遇到的主要挑战是什么，如何克服这些挑战？

核心洞察 ​

研究背景和目的 ​

新冠疫情（COVID-19）对癌症护理交付方式造成了前所未有的影响。本文旨在探讨加利福尼亚大学癌症联盟（UCCC）在疫情期间的应对和恢复计划，提出如何在后疫情时代重新设计癌症护理交付模型，以改善患者的护理体验和健康结果。

主要方法/材料/实验设计 ​

研究采用案例分析的方法，重点关注UCCC的五个综合癌症中心（UC Davis、UCLA、UC Irvine、UC San Diego和UCSF）在疫情期间的应对措施。各中心实施了多项干预措施，包括：

  1. 沟通与透明度：向患者和工作人员传达安全措施和恢复计划。
  2. 检测策略：增加无症状患者的COVID-19检测。
  3. 个人防护装备（PPE）和物理距离：制定每种医疗程序的PPE使用指南，并实施社交距离措施。
  4. 访客政策：在疫情初期实施无访客政策，后期根据需要进行调整。
  5. 远程医疗：扩展远程医疗的使用，以减少患者的医院访问需求。
Mermaid diagram

关键结果和发现 ​

  • 患者流量：在恢复计划实施后，患者就诊量增加了约15%。
  • 远程医疗的接受度：患者对远程医疗的接受度提高，尤其是对于那些居住较远的患者。
  • 健康不平等：疫情暴露了癌症患者群体中的健康不平等，特别是拉丁裔群体受到的影响更为严重。
  • 治疗调整：对系统治疗的调整，例如延长免疫治疗的给药间隔，以减少患者的医院就诊频率。

主要结论/意义/创新性 ​

本研究表明，疫情期间实施的多项措施为癌症护理的未来设计提供了重要经验。通过重新设计护理交付模式，UCCC不仅提高了患者的护理效率和安全性，还为未来可能出现的公共卫生危机提供了应对策略。该研究强调了健康系统在应对突发公共卫生事件时的灵活性和适应性。

研究局限性和未来方向 ​

  • 局限性：研究主要基于UCCC的经验，可能无法完全代表其他地区或国家的情况。
  • 未来方向：建议进一步研究如何在后疫情时代持续改进癌症护理交付，特别是在提高远程医疗服务的可及性和效果方面。此外，需要关注因疫情导致的健康不平等问题，确保所有患者都能获得公平的医疗服务。

参考文献 ​

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引用本文的文献 ​

  1. Planning for post-pandemic cancer care delivery: Recovery or opportunity for redesign? - Pelin Cinar;Richard Bold;Bryn A Bosslet;Daniela A Bota;Debra Burgess;Helen K Chew;Joshua G Cohen;Emad Elquza;Kathryn A Gold;Emi Kamiya;Beth Y Karlan;Rana R McKay;Sandip P Patel;Kimberly Ternavan;Jeanna Welborn;Maki Yamamoto;Hope S Rugo - CA: a cancer journal for clinicians (2021)
  2. Report from the Ready for the Next Round Thought-Leadership Roundtables on Building Resilience in Cancer Care and Control in Canada-Colorectal Cancer Canada; 2021. - Eliya Farah;Maria El Bizri;Radmila Day;Lavina Matai;Fred Horne;Timothy P Hanna;David Armstrong;Susan Marlin;Olivier Jérôme;Darren R Brenner;Winson Cheung;Laszlo Radvanyi;Eva Villalba;Natalie Leon;Chana Cohen;Karine Chalifour;Ronald Burkes;Sharlene Gill;Scott Berry;Brandon S Sheffield;Pamela Fralick;Barry D Stein; On Behalf Of Ready For The Next Round Patient Panelists - Current oncology (Toronto, Ont.) (2022)
  3. Experience of a National Cancer Institute-Designated Community Outreach and Engagement Program in Supporting Communities During the COVID-19 Pandemic. - Jessica D Austin;Kimberly Burke;Erica J Lee Argov;Grace C Hillyer;Karen M Schmitt;Jasmine McDonald;Rachel C Shelton;Mary Beth Terry;Parisa Tehranifar - Journal of community health (2022)
  4. Construction and experimental validation of a B cell senescence-related gene signature to evaluate prognosis and immunotherapeutic sensitivity in bladder cancer. - Ranran Zhou;Jiawei Zhou;Bahaerguli Muhuitijiang;Wanlong Tan - Functional & integrative genomics (2022)
  5. Fit for Duty: Lessons Learned from Outpatient and Homebound Hematopoietic Cell Transplantation to Prepare Family Caregivers for Home-Based Care. - A J Applebaum;T Sannes;H R Mitchell;N S McAndrew;L Wiener;J M Knight;A J Nelson;T F Gray;P M Fank;S C Lahijani;C Pozo-Kaderman;M Rueda-Lara;D M Miran;H Landau;H L Amonoo - Transplantation and cellular therapy (2023)
  6. Impact of the COVID-19 pandemic on cancer healthcare utilization in southwestern China on March 2021. - Peiyi Li;Yajuan Zhu;Yaqiang Wang;Xiaoyu Liu;Xiang Fang;Yuanxin Hou;Rujun Zheng;Junying Li;Bo Zhang;Zhuo Chen;Chengdi Wang;Tao Zhu;Weimin Li;Xuesong Han - Cancer medicine (2023)
  7. Top Ten Tips Palliative Care Clinicians Should Know About Caring for Family Caregivers. - Allison J Applebaum;Erin E Kent;Lee Ellington;Grace Campbell;Heidi Donovan;Ranak Trivedi;Courtney Van Houtven;Tamryn F Gray;Rebecca R Gebert;William E Rosa;J Nicholas Odom - Journal of palliative medicine (2024)
  8. The impact of the California state lockdown during the COVID-19 pandemic on management of patients with pancreatic ductal adenocarcinoma. - Parisa Oviedo;Shohei Burns;Wen-Pin Chen;Hanna K Mandl;Claudia Rosso;Niloofar Radgoudarzi;Anna Crosetti;Steven Zamora;Lauren M Perry;Richard J Bold;Amanda N Labora;Timothy R Donahue;Ajay Maker;Jennifer B Valerin;Jason A Zell;Rebekah R White - Journal of surgical oncology (2024)
  9. National Cancer Institute-funded grants focused on synchronous telehealth cancer care delivery: a portfolio analysis. - Roxanne E Jensen;Rachelle Brick;Joshua Medel;Priyanga Tuovinen;Paul B Jacobsen;Rebecca Hardesty;Robin C Vanderpool - Journal of the National Cancer Institute. Monographs (2024)
  10. Global determinants of gynecologic cancer incidence and mortality: A cluster-based analysis with predictive insights. - Mauricio A Cuello;Fernán Gomez-Valenzuela;Ignacio Wichmann;Alexander B Olawaiye - International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (2025)

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