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Scenarios cancer in primary care.

Velden, L.F.J. van der, Schellevis, F.G. Scenarios cancer in primary care.: , 2011. 29 p. Abstract. The Cancer and Primary Care Research International Network (Ca-PRI) 4th international Annual Meeting 'New pathways in cancer care: Substitution from Secondary to Primary Care?', 26-27 mei 2011, Noordwijkerhout. In: Abstractbook Ca-PRI 2011. Noordwijkerhout: The Cancer and Primary Care Research International Network, 2011.
Introduction: Previous studies predicted an increase in both the incidence and prevalence of cancer in the Netherlands. Other studies showed that cancer patients use primary care more frequently than non-cancer patients. Finally, during the “chronic phase” of the disease, task substitution from secondary to pri-mary care is foreseen by policymakers. Until now, the effects of an increase in the number of cancer patients and of task substitution on the demand for primary care were not investigated. Aim: To establish the effects of the increase in the number of cancer patients and task substitution on primary care in two different scenarios. The first scenario assumes “care as usual”. The second one is a “substitution” scenario. Methods: Demographic projections of the population were combined with trends in incidence and prevalence of cancer. The number of cancer patients in the “chronic phase” were estimated on the ratio between the incidence and prevalence. The “chronic phase” is the time between the acute phase (diagnosis and first treatment) and the terminal phase. For both 2010 and 2020 the number of people with and without “chronic cancer” were counted, split by sex and age group. The number of contacts per patient per sex and age group and for people with and without “chronic cancer” were combined with the total numbers of these people to assess the total amount of contacts. Results: The total demand for primary care from cancer patients in the “chronic phase” will grow with 66% in the “ care as usual” scenario. For the total amount of demand for primary care, this will lead to only a 1% extra growth in addition to the 6% growth that can be expected due to demographic developments. If per cancer patient in the “chronic phase” two control contacts will take place in primary care instead of secondary care, the total demand for primary care from cancer patients in the “chronic phase” will grow with 111%. So the growth of the demand for primary care from cancer patients in this “substitu-tion”scenario is much bigger than is the case in the “care as usual” scenario. However, the extra growth in the total demand for primary care is 4%. Conclusions: The number of cancer patients in the “chronic phase” will grow with about 66%. However, the impact of this considerable growth on the total amount of demand in primary care in a “care as usual”sce-nario is only 1%. The effect is small because this group of cancer patients is and will stay small in comparison to the total population. In a “substitution” scenario in which two of the control contacts in secondary care will take place in primary care, the total demand for primary care will grow by 4%. Although small, this amount of growth is substantial. Study performed by the working party 'Primary Care for Cancer Patients during Follow-up' of the Signalling Committee Cancer of the Dutch Cancer Society. (aut.ref)