澳大利亚昆士兰州癌症患者使用医疗保险慢性病管理项目编号的情况。

Md Mijanur Rahman, Shafkat Jahan, Bogda Koczwara, Mahesh Iddawela, Raymond J Chan, Elysia Thornton-Benko, Gail Garvey, Nicolas H Hart
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This includes utilisation of General Practitioner Management Plans (GPMP) and Team Care Arrangements (TCAs), reviews of GPMPs and TCAs, and engagement with allied health services until June 2018 following a cancer diagnosis. Results In total 47,615 (55%) and 43,286 (50%) people with cancer initiated at least one GPMP and TCA, respectively, with 31,165 (36%) receiving at least one review, and 36,359 (42%) utilising at least one allied health service (e.g. physiotherapists (41%), podiatrists (27%), exercise physiologists (19%)) with variations by cancer type. While people with cancer from disadvantaged socioeconomic groups had a higher likelihood of receiving GPMP (odds ratio, OR: 1.16, 95% confidence interval, CI: 1.11-1.21) and TCA (OR: 1.12, 95% CI: 1.07-1.16), they were less likely to utilise allied health services (OR: 0.89, 95% CI: 0.85-0.93). 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引用次数: 0

摘要

目的 慢性病在癌症患者中很常见。然而,澳大利亚的癌症患者对医疗保险慢性病管理(CDM)项目的使用情况仍未得到研究。本研究调查了与癌症患者有关的医疗保险 CDM 项目编号,包括全科医生 (GP) 和专职医疗 CDM 项目编号,以及任何相关的社会人口因素。方法分析了 2011 年 7 月至 2015 年 6 月期间在昆士兰癌症登记处登记的 86,571 名癌症患者的数据,以及医疗保险计划记录中截至 2018 年的 CDM 项目代码。其中包括全科医生管理计划(GPMP)和团队护理安排(TCA)的使用情况、全科医生管理计划和团队护理安排的复查情况以及癌症确诊后至 2018 年 6 月期间与专职医疗服务的接触情况。结果共有 47615 名癌症患者(55%)和 43286 名癌症患者(50%)分别启动了至少一项 GPMP 和 TCA,其中 31165 人(36%)接受了至少一次复查,36359 人(42%)利用了至少一项专职医疗服务(如物理治疗师(41%)、足病治疗师(27%)、运动生理学家(19%)),不同癌症类型之间存在差异。来自弱势社会经济群体的癌症患者接受 GPMP(几率比:1.16,95% 置信区间:1.11-1.21)和 TCA(几率比:1.12,95% 置信区间:1.07-1.16)的可能性较高,但他们利用专职医疗服务的可能性较低(几率比:0.89,95% 置信区间:0.85-0.93)。与居住在大都市的癌症患者相比,居住在偏远地区的癌症患者接受 TCA(OR:0.84,95% CI:0.80-0.88)或利用专职医疗服务(OR:0.63,95% CI:0.60-0.67)的可能性较低。为了了解癌症患者的护理需求是否得到满足,以及如何优化对这些患者的支持性护理,有必要进行进一步的探讨。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Utilisation of Medicare chronic disease management item numbers for people with cancer in Queensland, Australia.

Objective Chronic disease is common in people with cancer. However, the utilisation of Medicare chronic disease management (CDM) items for cancer patients in Australia remains unexplored. This study investigates Medicare CDM item numbers relating to people with cancer, including general practitioner (GP) and allied health CDM item numbers, and any associated sociodemographic factors. Methods Data from 86,571 people with cancer registered in the Queensland Cancer Registry between July 2011 and June 2015 and the CDM items codes from Medical Benefits Scheme records until 2018 were analysed. This includes utilisation of General Practitioner Management Plans (GPMP) and Team Care Arrangements (TCAs), reviews of GPMPs and TCAs, and engagement with allied health services until June 2018 following a cancer diagnosis. Results In total 47,615 (55%) and 43,286 (50%) people with cancer initiated at least one GPMP and TCA, respectively, with 31,165 (36%) receiving at least one review, and 36,359 (42%) utilising at least one allied health service (e.g. physiotherapists (41%), podiatrists (27%), exercise physiologists (19%)) with variations by cancer type. While people with cancer from disadvantaged socioeconomic groups had a higher likelihood of receiving GPMP (odds ratio, OR: 1.16, 95% confidence interval, CI: 1.11-1.21) and TCA (OR: 1.12, 95% CI: 1.07-1.16), they were less likely to utilise allied health services (OR: 0.89, 95% CI: 0.85-0.93). People with cancer living in remote areas were less likely to receive TCA (OR: 0.84, 95% CI: 0.80-0.88) or utilise allied health services (OR: 0.63, 95% CI: 0.60-0.67) than those in metropolitan areas. Conclusion Our findings underscore the need to examine uptake and implementation patterns of CDM items, especially in relation to clinical, social, and service provider-level factors and related potential barriers. Further exploration is warranted to understand whether people with cancer's care needs are being met and ways to optimise the supportive care of these people.

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