患者支援
6都県における情報提供と相談体制 がん医療ネットワークナビゲーターの普及に向けて
- 演 者：
- 渡邊 清高1，調 憲2, 浅尾 高行3, 相羽 惠介4, 佐々木 治一郎5, 藤 也寸志6, 竹山 由子6, 片渕 秀隆7,
境 健爾8, 吉田 稔9, 矢野 篤次郎10, 加藤 雅志11, 冨田 尚裕12, 西山 正彦13 - 所属機関：
- 1帝京大学・腫瘍内科, 2群馬大学・肝胆膵外科, 3群馬大学附属病院・先端医療開発センター, 4東京慈恵会医科大学, 5北里大学・新世紀医療開発センター, 6九州がんセンター, 7熊本大学・産科婦人科, 8熊本医療センター・腫瘍内科, 9日本赤十字社熊本赤十字病院・血液・腫瘍内科, 10別府医療センター・呼吸器外科, 11国立がん研究センター・がん対策情報センター・がん医療支援部, 12兵庫医科大学病院・下部消化管外科, 13群馬大学・病態腫瘍薬理学
Background/Aim
To provide reliable, well-organized information and scheme that can support patients and families in making their decision with assistance of professionals and caregivers.
Methods
We conducted comprehensive survey for 2,004 institutions in 6 prefectures (Gunma, Tokyo, Kanagawa, Fukuoka, Kumamoto, and Oita) about providing cancer information service and patient support system from October to December 2017. A questionnaire about category of care facilities (including hospitals, clinics, care centers, libraries, patient groups, etc.), difficulties in distributing cancer information (contents, training, collaboration, outreach, etc.).
Results
A total of 763 sites replied for survey (38.1%). Difficulties in providing information are categorized to resource (shortage of staff, time and space), contents (information, booklets, web), communication and training programs. Information needs were emphasized especially on care at home, palliative care, expenditures, psychological support, communication with health professionals, side effects, treatment, transfer, nursing. Health professionals and patient advocates were engaged in information providers, and they expressed hope in incorporation into local network including Cancer Network Navigators.
Conclusion
Distribution program of Cancer Network Navigator aims to achieve positive outcomes for patients by developing an integrated and seamless system for providing information to patients and carers that helps them better managing their own care.
がん診断後の就労状況を医療保険で観察―大阪府がん登録と多施設DPCデータからの知見
- 演 者：
- 森島 敏隆1，佐藤 亮1, 中田 佳世1, 松本 吉史2, 小枝 伸行3, 島田 裕子4, 丸濱 勉5, 松木 大作6, 宮代 勲1
- 所属機関：
- 1大阪国際がんセンター・がん対策センター, 2大阪医科大学附属病院, 3八尾市立病院, 4大阪南医療センター, 5東住吉森本病院, 6吹田病院
<Introduction> It has been emerged as a social problem that there are many cancer patients who are obliged to quit their job after cancer diagnosis. Questionnaire surveys for grasping job status have limitations in terms of its costs and sampling techniques of the target population.
<Aim> To observe health insurance switch as a proxy for change in employment status of cancer patients, using existing data.
<Methods> We performed a record linkage of population-based cancer registry data from Osaka Prefecture and DPC data from 36 designated cancer care hospitals. The study population comprised beneficiaries of health insurance for salaried employees who were between 25 and 64 years of age and received a diagnosis of cancer between 2010 and 2015. Information of insurance status at diagnosis and one year after diagnosis was extracted from DPC data. Patient data from cancer registry included sex, age, site of cancer, stage, treatment, and date of diagnosis. We calculated the percentages of switching insurance among the patients within one year after diagnosis, stratified by a variety of subgroups.
<Results> A total of 17,280 patients were analyzed and 2,288 (13.2%) switched their insurance within one year after diagnosis. The percentage of switching insurance was higher among women and lowest among patients 40 to 54 years of age. The highest percentage was lung (17.3%), followed by cervix uteri (17.1%) for site of cancer; distant (21.7%), followed by unknown (14.7%) for stage; chemotherapy (19.2%), followed by chemoradiotherapy (18.3%) for treatment. Percentages stratified by health insurer were 14.6%, 12.3%, and 9.8% for Health Insurance Association (Kyoukai Kenpo), Union-managed Health Insurance (Kenpo Kumiai), and Mutual Aid Association (Kyosai Kumiai), respectively.
<Conclusions> We were able to conducted descriptive epidemiology studies of cancer patients’ job status, making secondary use of existing data.
