Cancer Care Coordination: a Systematic Review and Meta-Analysis of Over 30 Years of Empirical Studies

Abstract Background According to a landmark study by the Institute of Medicine, patients with cancer often receive poorly coordinated care in multiple settings from many providers. Lack of coordination is associated with poor symptom control, medical errors, and higher costs. Purpose The aims of thi...

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Bibliographic Details
Published in:Annals of behavioral medicine 2017-08, Vol.51 (4), p.532-546
Main Authors: Gorin, Sherri Sheinfeld, Haggstrom, David, Han, Paul K. J., Fairfield, Kathleen M., Krebs, Paul, Clauser, Steven B.
Format: Article
Language:English
Subjects:
Cancer
Case management
Case reports
Continuity of care
Family Medicine
General Practice
Health Psychology
Medicine
Medicine & Public Health
Meta-analysis
Original Article
Systematic review
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Summary:Abstract Background According to a landmark study by the Institute of Medicine, patients with cancer often receive poorly coordinated care in multiple settings from many providers. Lack of coordination is associated with poor symptom control, medical errors, and higher costs. Purpose The aims of this systematic review and meta-analysis were to (1) synthesize the findings of studies addressing cancer care coordination, (2) describe study outcomes across the cancer continuum, and (3) obtain a quantitative estimate of the effect of interventions in cancer care coordination on service system processes and patient health outcomes. Methods Of 1241 abstracts identified through MEDLINE, EMBASE, CINAHL, and the Cochrane Library, 52 studies met the inclusion criteria. Each study had US or Canadian participants, comparison or control groups, measures, times, samples, and/or interventions. Two researchers independently applied a standardized search strategy, coding scheme, and online coding program to each study. Eleven studies met the additional criteria for the meta-analysis; a random effects estimation model was used for data analysis. Results Cancer care coordination approaches led to improvements in 81 % of outcomes, including screening, measures of patient experience with care, and quality of end-of-life care. Across the continuum of cancer care, patient navigation was the most frequent care coordination intervention, followed by home telehealth; nurse case management was third in frequency. The meta-analysis of a subset of the reviewed studies showed that the odds of appropriate health care utilization in cancer care coordination interventions were almost twice (OR = 1.9, 95 % CI = 1.5–3.5) that of comparison interventions. Conclusions This review offers promising findings on the impact of cancer care coordination on increasing value and reducing healthcare costs in the USA.
ISSN:0883-6612
1532-4796
DOI:10.1007/s12160-017-9876-2