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

作者：Sherri Sheinfeld Gorin, David Andrew Haggstrom, Paul K. J. Han, Kathleen M. Fairfield, Paul M. Krebs, Steven B. Clauser · 发表于：Annals of Behavioral Medicine · 年份：2017 · DOI：10.1007/s12160-017-9876-2 · 被引用次数：278 · 研究领域：Global Cancer Incidence and Screening、Cancer survivorship and care、Healthcare Systems and Technology

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 frequ...