Research Brief: U.S. Cancer Care Facing Crisis

IOM Cancer CrisisA report from the Institute of Medicine (IOM) released September 10, 2013 calls the system of cancer care in the United States a crisis. The 17-member IOM committee that wrote the report, “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis,” was charged with examining opportunities for, and challenges to, the delivery of high-quality cancer care as well as developing recommendations for improvement. The committee reviewed the coordination, organization, complexity, and costs of care; payment reform, disparities and access to high-quality care; quality metrics and outcomes reporting; and the growing need for survivorship care, palliative care, and family caregiving. The take-home message: “Cancer care is often not as patient centered, accessible, coordinated, or evidence based as it could be.” 

Contributing to the crisis in cancer care is the sheer growing number of people who are facing cancer diagnoses coupled with a shortage in the number of health professionals who are skilled in providing cancer care. The committee also found a lack of coordination among physicians, poor communication between doctors and patients, inattention to quality of life and palliative care, and a cost-for-services that was extremely high and unsustainable.

Recommendations

  1. Provide patients and their families with understandable information about cancer prognosis, treatment benefits and harms, palliative care, psychosocial support, and costs.
  2. Provide patients with end-of-life care that meets their needs, values, and preferences.
  3. Ensure coordinated and comprehensive patient-centered care.
  4. Ensure that all individuals caring for cancer patients have appropriate core competencies.
  5. Expand the breadth of data collected in cancer research for older adults and patients with multiple comorbid conditions.
  6. Expand the depth of data collected in cancer research through a common set of data elements that capture patient-reported outcomes, relevant patient characteristics, and health behaviors.
  7. Develop a learning health care information technology system for cancer that enables real-time analysis of data from cancer patients in a variety of care settings.
  8. Develop a national quality reporting program for cancer care as part of a learning health care system.
  9. Implement a national strategy to reduce disparities in access to cancer care for underserved populations by leveraging community interventions.
  10. Improve the affordability of cancer care by leveraging existing efforts to reform payment and eliminate waste.

Report At a Glance

  • Briefing Slides (PDF)
  • Press Release (HTML)
  • Questions for Patients with Cancer to Ask Their Care Team (PDF)
  • Report Brief (PDFHTML)
  • Videos (HTML)
Source: Laura Levit, Erin Balogh, Sharyl Nass, and Patricia A. Ganz, Editors. 2013. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. Institute of Medicine, The National Academies Press, Washington, D.C.

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