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O estado do cuidado do cancer

por Loren Bonner, DOTmed News Online Editor | October 07, 2013
From the October 2013 issue of HealthCare Business News magazine

We've all heard the call for more coordinated care in our health care system. It's a popular catch phrase these days in any discussion about pushing forward with a revamped system that delivers quality care -- another popular catch phrase. While coordinated care is a good idea in every part of the system, I think the call is most urgent in cancer care.

I read the recent Institute of Medicine Report, which goes so far as to say our country is being faced with a cancer care crisis. As a journalist I'm a pretty skeptical person, but I think there is truth to this claim. I have been fortunate to not have been personally affected by cancer -- face-to-face or with anyone close to me. But the odds are against us all: there is a good chance I, or someone I love, will have to deal with cancer one day. A strong risk factor for cancer is age -- it normally hits around age 66. So think about this: In 2011, the first wave of baby boomers turned 65. By 2030, it's estimated that the number of cancer cases will rise to 2.3 million per year from about 14 million per year, which is where it stands today. That's an increase of 45 percent. One part of the crisis, the IOM report points out, is the growing demand for cancer care.

Now, think about the cost increase that this will bring to our already overburdened health care system. According to the IOM, cancer care costs are expected to reach $173 billion by 2020, up from $125 billion in 2010 and $72 billion in 2004.

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You would hope that when a patient is faced with something as devastating as cancer, the health care system would serve the patient well. Instead, patients are often left trying to coordinate their own care among different specialists. That's just not right for someone who is already physically and emotionally exhausted -- and not every cancer patient is fortunate enough to have close friends or family there to help them. This certainly makes a good case for shared medical records across all systems.

Another thing the report calls for is patient-centered care. The IOM urges doctors to engage with patients on which course of treatment they would like to pursue, which could mean a discussion on palliative care, psychosocial support, and costs of care. The IOM is a respected institution, with a broad purpose to provide national advice on important medical topics. The hope is that policy makers and medical professionals can take this information seriously because a new model of cancer care would call for updated training and some fundamental changes to how cancer care is reimbursed.

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