scholarly journals Rethinking cancer surveillance with shared-care models and survivorship plans: the time is now!

2017 ◽  
Vol 119 (3) ◽  
pp. 360-361
Author(s):  
Matthew T. Gettman
Keyword(s):  
Shared Care ◽  
Cancer Surveillance ◽  
Care Models

Clinical update on public and private psychiatric practice shared-care partnerships – Can the twain work together?

2021 ◽  
pp. 103985622110528
Author(s):  
Jeffrey C.L. Looi ◽  
Michelle Atchison ◽  
May Matias
Keyword(s):  
Policy Development ◽  
Health Sector ◽  
Mental Healthcare ◽  
Shared Care ◽  
Psychiatric Practice ◽  
Public And Private ◽  
Health Strategy ◽  
Care Models ◽  
Private And Public ◽  
National Mental Health

Objective: We explore the previous research and current context regarding opportunities for shared-care partnerships between public and private psychiatric practice. Conclusions: Since the early 2000s, when there was impetus for the development of public-private psychiatric shared-care models as part of a previous National Mental Health Strategy, there has been surprisingly little research and policy development. Given an apparent exodus of psychiatrists to private practice due to current challenges facing the public health sector, it is timely to reconsider models of private and public sector shared-care that may improve the quality of public mental healthcare.

scholarly journals Association of Shared Care Networks with Heart Failure Excessive Hospital Readmissions

2021 ◽  
Author(s):  
Diego Pinheiro ◽  
Ryan Hartman ◽  
Jing Mai ◽  
Erick Romero ◽  
Saad Soroya ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Readmissions ◽  
Unintended Consequences ◽  
Shared Care ◽  
Control Mechanisms ◽  
Hospital Discharges ◽  
Localization Index ◽  
Black Residents ◽  
Care Models ◽  
The Impact

Objectives: This study aimed to evaluate the impact of shared care networks on heart failure readmission rates. Background: Higher-than-expected heart failure (HF) readmissions affect half of US hospitals every year. The Hospital Reduction Readmission Program (HRRP) has reduced risk-adjusted readmissions, but it has also produced unintended consequences. Shared care models have been advocated for HF care, but the association of shared care networks with HF readmissions has never been investigated. Methods: We curated publicly available data on hospital discharges and HF excessive readmission ratios (ERRs) from hospitals in California between 2012 and 2017. Shared Care Areas (SCAs) were delineated as data-driven units of care coordination emerging from discharge networks. The localization index (LI), the proportion of patients who reside in the same SCA in which they are admitted, were calculated by year. Generalized estimating equations (GEE) were used to evaluate the association between the LI and the ERR of hospitals controlling for race/ethnicity and socioeconomics factors. Results: A total of 300 hospitals in California in a 6-yr period were included. The HF excessive readmission ratio (ERR) was negatively associated with the localization index (beta: -0.0474; 95% CI: -0.082 to -0.013). The percentage of Black residents within the SCAs was the only statistically significant covariate (beta: 0.4128; 95% CI: 0.302 to 0.524). Conclusions: Higher-than-expected HF readmissions were associated with shared care networks. Control mechanisms such as the HRRP may need to characterize and reward shared care to guide hospitals towards a more organized HF care system.

A comparison of primary care providers’ and oncologists’ preferences for different models of cancer survivorship care.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 6006-6006
Author(s):  
Winson Y. Cheung ◽  
Anne Michelle Noone ◽  
Noreen Aziz ◽  
Julia Howe Rowland ◽  
Arnold L. Potosky ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Survivorship ◽  
Primary Care Providers ◽  
Shared Care ◽  
Physician Attitudes ◽  
Primary Role ◽  
Survivorship Care ◽  
Care Models ◽  
Care System

6006 Background: There is increasing interest in developing more efficient and effective strategies for coordinating and delivering cancer and non-cancer related follow-up care to survivors. The objectives of this nationwide survey were to describe and compare US physician preferences for different cancer survivorship care models. Methods: The Survey of Physician Attitudes Regarding the Care of Cancer Survivors (SPARCCS) was mailed to PCPs and oncologists in order to evaluate their views regarding physician responsibilities, knowledge levels about survivorship, and cancer follow-up testing. Using weighted univariate and multivariate models, we analyzed PCPs’ and oncologists’ preferences for different cancer survivorship care models (PCP/shared vs. oncologist vs. non-physician provider) and examined how physician attitudes towards and self-efficacy with their own skills during breast and colorectal cancer follow-up affected these preferences. Results: Of 3,434 physicians surveyed, 2,202 (64%) responded of whom 2,026 (59%) provided eligible outcomes for this study: 938 (46%) PCPs and 1,088 (54%) oncologists. In unadjusted analyses, most PCPs (51%) supported a PCP/shared care system whereas the majority of specialists (59%) strongly endorsed an oncologist-based model (p<0.001). A number of PCPs and oncologists (23% for both) preferred to involve non-physician providers. A significant proportion of cancer specialists (87%) did not feel that PCPs can take on the primary role for cancer follow-up. Many PCPs believed that they have the skills to perform breast and colorectal cancer follow-up (57%), detect recurrent cancers (74%), and offer psychosocial support (50%), but only a minority (32%) were willing to assume exclusive responsibility. In adjusted analyses, PCPs already involved with cancer surveillance (43%) were more likely to prefer a PCP/shared care system than an oncologist-based survivorship care model (OR 2.08, 95%CI 1.34-3.23, p<0.001). Conclusions: PCPs and oncologists have different preferences for models of cancer survivorship care. Prior involvement with cancer follow-up was one of the strongest predictors of PCPs' willingness to assume this responsibility.

scholarly journals Roles and recommendations from primary care physicians towards managing low-risk breast cancer survivors in a shared-care model with specialists in Singapore—a qualitative study

2020 ◽  
Vol 37 (4) ◽  
pp. 547-553
Author(s):  
Rose Wai-Yee Fok ◽  
Lian Leng Low ◽  
Hui Min Joanne Quah ◽  
Farhad Vasanwala ◽  
Sher Guan Low ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Survivors ◽  
Primary Care Physicians ◽  
Breast Cancer Survivors ◽  
Medical Information ◽  
Shared Care ◽  
Cancer Surveillance ◽  
Care Programme ◽  
Care Protocol

Abstract Background Breast cancer is prevalent and has high cure rates. The resultant increase in numbers of breast cancer survivors (BCS) may overwhelm the current oncology workforce in years to come. We postulate that primary care physicians (PCPs) could play an expanded role in comanaging survivors, provided they are given the appropriate tools and training to do so. Objective To explore the perspectives of PCPs towards managing BCS in a community-based shared-care programme with oncologists. Methods Eleven focus groups and six in-depth interviews were conducted with seventy PCPs recruited by purposive sampling. All sessions were audio-recorded, transcribed verbatim and coded by three independent investigators. Thematic data analysis was performed and the coding process facilitated by NVivo 12. Results Majority of PCPs reported currently limited roles in managing acute and non-cancer issues, optimizing comorbidities and preventive care. PCPs aspired to expand their role to include cancer surveillance, risk assessment and addressing unmet psychosocial needs. PCPs preferred to harmonize cancer survivorship management of their primary care patients who are also BCS, with defined role distinct from oncologists. Training to understand the care protocol, enhancement of communication skills, confidence and trust were deemed necessary. PCPs proposed selection criteria of BCS and adequacy of their medical information; increased consultation time; contact details and timely access to oncologists (if needed) in the shared-care programme. Conclusions PCPs were willing to share the care of BCS with oncologists but recommended role definition, training, clinical protocol, resources and access to oncologist’s consultation to optimize the programme implementation.

Predicting adherence to colorectal cancer surveillance after plypectomy

2001 ◽  
Vol 120 (5) ◽  
pp. A602-A602
Author(s):  
S RAWL ◽  
S BLACKBURN ◽  
L HACKWARD ◽  
N FINEBERG ◽  
T IMPERIALE ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Surveillance ◽  
Colorectal Cancer Surveillance
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