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abstract
Background Recently,
the concept of integrating oncology and palliative care has gained wide
professional and scientific support; however,
a global consensus on what constitutes
integration is unavailable. We conducted a Delphi Survey to develop a
consensus list
of indicators on integration of specialty
palliative care and oncology programs for advanced cancer patients in
hospitals
with ≥100 beds.
Methods International
experts on integration rated a list of indicators on integration over
three iterative rounds under five categories:
clinical structure, processes, outcomes,
education, and research. Consensus was defined a priori by an agreement
of ≥70%.
Major criteria (i.e. most relevant and important
indicators) were subsequently identified.
Results Among 47
experts surveyed, 46 (98%), 45 (96%), and 45 (96%) responded over the
three rounds. Nineteen (40%) were female,
24 (51%) were from North America, and 14 (30%)
were from Europe. Sixteen (34%), 7 (15%), and 25 (53%) practiced
palliative
care, oncology, and both specialties,
respectively. After three rounds of deliberation, the panelists reached
consensus on
13 major and 30 minor indicators. Major
indicators included two related to structure (consensus 95%–98%), four
on processes
(88%–98%), three on outcomes (88%–91%), and four
on education (93%–100%). The major indicators were considered to be
clearly
stated (9.8/10), objective (9.4/10), amenable to
accurate coding (9.5/10), and applicable to their own countries
(9.4/10).
Conclusions Our international experts reached broad consensus on a list of indicators of integration, which may be used to identify centers
with a high level of integration, and facilitate benchmarking, quality improvement, and research.
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