Ensuring Quality Cancer Care (1999) / Chapter Skim
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8 Findings and Recommendations
8 Findings and Recommendations
Pages 211-225
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From page 211... ...
8 Findings and Recommendations The findings and recommendations listed in Box I ~ are based on the evidence reviewed in previous chapters, which includes literature reviews, compilations of data, and summaries of key findings.
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I ~ :. ~ Recom~mend~ation:~:~.~8:~P~u~bli~¢~;~a-~n~p~rl~vate~spo~nsors ~ of cancer ~Ca~re~;research~sho~u~ld~:su~p~pod~: I; .' national Studies Of Recently: Diagnosed ~indiv~d~ua~l~s ~ w~ith cancer ~ using: i~n~rmation ~ so-es ~:~ |~-~with~s;~ffic~ient detall~to assess patterns ~f~can:cer~:care~and~:o~rs associated~:wi~th~i:h~e~t~ ~.~ ~ ~ a; ~ ~ ~ ~ ~ of ~ ~.:~ -: :~ ~: ~ ~:~ ~ :: ~ ~ ~ .
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From page 214... ...
. The TOM National Roundtable on Health Care Quality concluded that current attempts to improve quality will not succeed unless major, systemic efforts are undertaken to overhaul the way in which health care services are delivered, physicians are educated and trained, and quality is assessed (Chassin et al., 1998)
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From page 215... ...
Certainly, issues related to quality cancer care have to be addressed at the national and state levels, in coordination with other quality-of-care efforts. Of note is the creation of organizations to implement recommendations of the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry.
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From page 216... ...
Treatment of early breast cancer saves lives, and early detection through screening contributes to early diagnosis, when treatment is most effective. When established quality measures have been used to assess the care women receive, the following quality problems have been identified: of pathology studies)
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RECOMMENDATION 2: Use systematically developed guidelines based on the best available evidence for prevention, diagnosis, treatment, and palliafive care. Total quality improvement initiatives, disease management programs, and implementation of clinical practice guidelines all have the potential to improve care within health systems.
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Cancer care quality measures should be used to hold providers, inclu(ling health care systems, health plans, and physicians, accountable for demonstrating that they provide and improve quality of care.
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For Medicare beneficiaries in managed care plans, accountability systems should incorporate core measures of quality cancer care. Cancer care quality measures should be applied to care provided through the Medicare and Medicaid programs as a requirement for participation in these programs.
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RECOMMENDATION 4: Ensure the following elements of quality care for each individual with cancer: . that recommendations about initial cancer management, which are critical in determining long-term outcome, are made by experienced professionals; · an agreed-upon care plan that outlines goals of care; · access to the full complement of resources necessary to implement the care plan; · access to high-quality clinical trials; · policies to ensure full disclosure of information about appropriate treatment options; · a mechanism to coordinate services; and · psychosocial support services and compassionate care.
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From page 221... ...
RECOMMENDATION 6: Federal and private research sponsors such as the National Cancer Institute, the Agency for Health Care Policy and Research, and various health plans should invest in clinical trials to address questions about cancer care management. For some questions regarding cancer management, a health services research component could possibly be integrated into a clinical trial designed to assess the efficacy of a new treatment.
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From page 222... ...
cancer registry, maintained by the National Cancer Institute (NCI) , when linked to Medicare and other insurance administrative files, has been valuable in assessing the quality of care for the elderly and other insured populations.
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Data gathered into national databases' in particulars should be made available quickly for analysis by investigators and evaluators. RECOMMENDATION 8: Public and private sponsors of cancer care research should support national studies of recently diagnosed individuals with cancer, using information sources with sufficient detail to assess patterns of cancer care and factors associated with the receipt of good care.
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These programs and services cannot substitute for adequate insurance coverage for cancer treatment, but they can ease the financial burden for those eligible to receive them. Although having health insurance coverage improves access, it does not guarantee good care.
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A Report to Congress for the Nation. National Cancer Policy Board.
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