Abstract
Effective care coordination (CC) is a hallmark of a high-quality cancer care. However, efforts to improve cancer care delivery are limited by the lack of a clinically useful tool to assess CC. In this study, we examined patients' perceptions of cancer CC using a novel tool, the Care Coordination Instrument (CCI), and evaluated the quality of the CCI. The CCI is a 29-item patient questionnaire that assesses CC across varied practice settings and patient populations overall and for three critical domains of CC: communication, navigation, and operational. We conducted univariable and multivariable regression analyses to identify patient clinical and practice characteristics associated with optimal versus suboptimal CC. Two hundred patients with cancer completed the CCI questionnaire between October 2018 and January 2019, of whom 189 were used for the analysis. The presence of a family caregiver and a diagnosis of a blood cancer were correlated with overall positive reports of CC (P < .001 and P < .05, respectively). Poorer perceptions of CC were associated with having a head and neck cancer and the absence of family caregiver support. The effects of cancer disease stage and having access to a patient navigator on CC were not statistically significant. Integrating a patient-centered tool to assess cancer CC can be a strategy to optimize cancer care delivery. Understanding factors associated with effective and ineffective CC can help inform efforts to improve overall quality of care and care delivery.
Highlights
Care coordination (CC) during cancer treatment is a critical component of patient-centered care.[1]
The presence of a family caregiver and a diagnosis of a blood cancer were correlated with overall positive reports of CC (P, .001 and P, .05, respectively)
Poorer perceptions of CC were associated with having a head and neck cancer and the absence of family caregiver support
Summary
Care coordination (CC) during cancer treatment is a critical component of patient-centered care.[1]. A hallmark of high-quality care is a coordinated, patient-centered approach; many patients with cancer continue to receive poor and fragmented care.[1,3,4] Poorly coordinated care can result in medical errors, adverse patient outcomes, and spiraling health care costs due to test duplication, overuse of emergency services, and unplanned hospital admissions.[5,6,7,8] Given the increasing complexity of anticancer interventions and rapid expansion of multimodal treatments requiring greater coordination of care, it is important to gain understanding of current CC approaches and develop evidence-based, innovative approaches to improve the efficiency and effectiveness of care delivery. Multiple barriers to improve cancer care delivery exist. Lack of adequate measurement instruments has been identified as a barrier to e726 Volume 16, Issue 8
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