Chinese Medical Sciences Journal ›› 2018, Vol. 33 ›› Issue (4): 204-209.doi: 10.24920/003523

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基于价值评估的医疗实践: 将肿瘤康复和缓和医疗整合在癌症患者医疗服务中

朱意   

  1. 美国放射学院费城,宾夕法尼亚州19103, UAS
  • 收稿日期:2018-09-28 接受日期:2018-10-22 出版日期:2018-12-30 发布日期:2019-01-10

Value-based Practice: Integration of Cancer Rehabilitation and Palliative Care in Oncology Services

Zhu Yi   

  1. American College of Radiology, Philadelphia, PA 19103, USA
  • Received:2018-09-28 Accepted:2018-10-22 Published:2018-12-30 Online:2019-01-10

摘要:

以价值体系为评估标准的医疗服务是围绕患者的疾病需求来组织和提供全周期的完整的医疗服务模式。这种全周期的医疗服务是以住院、门诊、康复设施为场地,除了传统的医疗手段,还包括缓和医疗,营养支持性治疗在内的完整的医疗计划和服务模式。肿瘤康复和缓和医疗已经开始成为肿瘤治疗计划中有重要价值的两个组成部分。越来越多的临床证据表明,疾病早期时肿瘤康复的介入和缓和医疗干预会改善患者预后并降低患者、家庭和医疗服务机构的整体医疗费用。在中国,虽然越来越多的肿瘤学专家开始关注这两个亚专科,但这两项医疗服务如何嵌入到现有医疗体制下的临床实践中,尚未得到有效性的研究和验证。医护人员深入了解肿瘤康复和缓和医疗的作用及工作范畴有助于两项服务有效融入到肿瘤治疗的延续照护计划中,以促进肿瘤患者在生理、心理、认知和功能方面的健康,提高其生活质量。

关键词: 肿瘤康复, 缓和医疗, 安宁疗护, 失能, 生活质量

Abstract:

Value-based care model has been evolving to organize medical services around the patient and provide the full cycle of care for a medical condition. The full cycle of care model encompasses inpatient, outpatient, rehabilitation as well as supportive care such as palliative care and nutrition support. Cancer rehabilitation and palliative care have emerged as two important parts of value-based practice for oncology patients. More clinical evidence suggests that early intervention of oncology rehabilitation program and palliative care are likely to improve the patient outcome and reduce the overall medical cost for the patient and his or her family as well as for medical service providers. Although interest has been raised in Chinese oncologists, but effectiveness of incorporating these two services in clinical practices has not been adequately demonstrated. An understanding of scope of cancer rehabilitation and palliative care may help facilitate the integration of both into the oncology care continuum in efforts to improve patients’ physical, psychological, cognitive, functional health and quality of life.

Key words: cancer rehabilitation, palliative care, hospice, disability, quality of life

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