Reply by Authors.

Improve care coordination is the answer but how do we do it? Operative outcomes have improved substantially in recent years due to significant advances in perioperative care, including regionalization of care to higher volume centers, ERAS (Enhanced Recovery after Surgery) protocols and other quality improvement efforts. Meanwhile, little progress has been made to reduce morbidity after patient discharge from the hospital. As documented in the current study of RP, readmission rates remain high and outcomes vary after readmission. These investigators found that readmission to a nonindex hospital (a hospital different than where surgery was performed) resulted in more procedures and higher costs than readmission to the index hospital. Prior studies have also demonstrated better clinical outcomes, such as a lower rate of failure to rescue, at index hospitals compared to nonindex hospitals. The authors conclude that increased care coordination is needed to improve the outcomes and decrease the costs associated with readmissions. But what is care coordination and how do we improve it? Most clinicians agree that good care coordination is important for high value cancer care. However, we have limited understanding of what strategies are effective to improve cancer care coordination. Research that advances our understanding of effective care coordination is critical to improve cancer care delivery. The NCPF (National Cancer Policy Forum) has identified this as a priority and the NCI (National Cancer Institute) recently issued a Notice of Special Interest for research focused on improving “interprofessional teamwork and coordination during cancer diagnosis and treatment.” The implications of this research will be far reaching, impacting not only value based care models such as those highlighted in this study but also other overarching issues in cancer care delivery, including fragmentation of care, racial disparities and geographic barriers to care.

• Publication year

  2019

• Venue

  Journal of Urology

• Publication date

  2019-11-26

• Fields of study

  Medicine

• Identifiers
  DOI 10.1097/JU.0000000000000522.03PMID 31769720
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Cancer care coordination: opportunities for healthcare delivery research.

  2018cited by this paper
• Readmission destination and risk of mortality after major surgery: an observational cohort study.

  2015cited by this paper

• No citing papers are available for this paper.