Is there a role for Primary Care in the follow-up of colorectal cancer patients?: the case of a Portuguese university hospital

• Autor(a) principal: Bandarra, Maria Margarida Costa Ferreira
• Data de Publicação: 2018
• Outros Autores: Escoval, Ana, Costa, Luís Marques da
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10362/112789
• topic: Integration of care; Disease management; Colorectal cancer; Follow-up; Survivorship; Integração de cuidados; Gestão da doença; Cancro colorretal; Seguimento; Sobrevivente

ABSTRACT - Background: In Portugal, colorectal cancer is the second most common type of cancer. With the increasing number of cancer survivors, follow-up is perceived as a chronic disease, with a significant impact on hospital care. Objective: To characterize colorectal patients in follow-up at Centro Hospitalar Lisboa Norte, EPE, and to determine the profile of economic resources consumed as well as the consultation workload. Materials and Methods: We characterized colorectal patients in follow-up at Centro Hospitalar Lisboa Norte, EPE, registered from 2008 until 2013 and the profile of economic resources consumed. Results: The Department of Oncology is responsible for 56.2% of colorectal patients’ follow- up. In this study, only 0.4% of cases had follow-up secured in primary care, which translates to a significant impact in terms of resources allocation and consultation management, especially if we consider that 41% of patients are in follow-up for longer than 3 years. The average annual adjusted cost of follow-up per patient is EUR 539.09. Patients who were alive on 31 January 2014 had generated 2,930 follow- up hospital appointments per year, representing 12% of the total number of oncology appointments reported in 2013. Discussion and Conclusions: The follow-up of colorectal cancer patients is associated with significant hospital resource allocation and physicians’ time consumption. Other follow-up models might emerge as an alternative to traditional hospital-centered follow-up, such as the shared-care follow-up, which requires a multidisciplinary and survivorcentered approach, ensuring that information and communication are shared between settings with a clear definition of responsibilities, a survivor care plan, and mechanisms for future referencing when justified.