Abstract

BANDARRA, Maria Margarida Costa Ferreira; ESCOVAL, Ana  and  COSTA, Luís Marques da. Is There a Role for Primary Care in the Follow-Up of Colorectal Cancer Patients? The Case of a Portuguese University Hospital. Port J Public Health [online]. 2018, vol.36, n.2, pp.72-80. ISSN 2504-3137.  https://doi.org/10.1159/000492345.

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 survivor-centered 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.

Keywords : Follow-up; Survivorship Integration of care; Disease management; Colorectal cancer.

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