Evaluating the patient-centered quality of cancer survivorship care models.

Abstract

48 Background: With 15.5 million cancer survivors in the U.S., cancer is increasingly viewed as a chronic illness that requires systematic, coordinated care. Yet research has not determined what models of survivorship are most effective in providing high quality, patient-centered care. This study evaluates the quality of three models of cancer survivorship care using a newly developed patient-centered measure. Methods: We conducted a comparative effectiveness study with 32 cancer programs distributed across 3 distinct models of survivorship care: 1) Consultative Specialized Survivorship Clinic; 2) Longitudinal Specialized Survivorship Clinic; and 3) Oncology-Embedded Survivorship Clinic with Referrals. We developed the Patient-Prioritized Measure of High Quality Survivorship Care (PPM), a scale comprising 9 patient-prioritized components of survivorship care. We enrolled 991 survivors of breast, colorectal and prostate cancer across these programs and followed them over 6 months collecting self-reported data on quality of survivorship services. Results: Preliminary results suggest statistically significant differences across models of care for six PPM components. Model 1 is more likely than the other two models to provide a full spectrum of services (p=0.0001), mental health and social support (p<0.0001), and information and resources for patients in survivorship (p=0.0002). Model 2 is better than model 3 at providing a medical home (0.04), and outperforms both other models at coordinating care and transitions (p=0.0059). Both Models 1 and 2 are better than model 3 in ensuring productive patient-provider interactions (p=0.006). Conclusions: It appears that certain models of survivorship care are better at specific domains of patient-centered quality, suggesting cancer centers should consider their organizational context and their patients’ needs before committing to a particular model of care.