Abstract 4757
Background
The challenge faced by the cancer patient is access to care and for the health system, thenon-availability of qualified personnel. Besides financial issues, patients face challenges of finding a cancer center. Governments are keen to offer universal health coverage but are in need of sustainable systems. A novel healthcare delivery system was designed and has been operational in several states of India.
Methods
General duty medical officers and nurses from government district hospitals were trained in oncology for one month. Various administrative reforms, restructuring and techno-mentoring (constant, 24x7, mentorship using WhatsAppR, Telephonic communication, regular continuing medical education) were used to create a system of health care delivery in oncology. The drug distribution system was changed to include essential oncology drugs.
Results
A district cancer care programme has been initiated in six states of India, involving 157 hospitals constituting about 20 % of the nation. The hospital has a nodal cancer unit, with nodal cancer officer and nurse in charge to deliver cancer services, such as counselling at all stages of care, assistance in diagnostics, (which may vary from biopsy to scan to tumor markers), follow up care, palliative care, end of life care and, most importantly, chemotherapy. A patient from the district has a choice of conitnuum of care at local hospital to which he is used. He can visit more frequently with no cost involved. This system change and empowerment has allowed the government to bring care closer to the facility and help patients gain access. A satisfaction survey done amongst patients shows there is a strong willingness to follow in districts.This is saving thousand of families from impoverishment. The creation of a system of cancer care delivery has led to other states following this example. From one state it has gone to six states,(population coverage of around 300 million).
Conclusions
Primary care physicians can be effectively empowered to offer specialised cancer care in government-run facilities. This duplicable, sustainable model (Pendharkar model) using existing human resources can be used by many countries fighting with shortages of personnel and access issues.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Dinesh Pendharkar.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.
Resources from the same session
4614 - Predictors of Response to Checkpoint Inhibitors in Naïve and Ipilimumab-Refractory Melanoma
Presenter: Domenico Mallardo
Session: Poster Display session 3
Resources:
Abstract
2901 - IFN-γ/IL-10 ratio as predictive biomarker for response to anti-PD-1 therapy in metastatic melanoma patients
Presenter: Emilio Giunta
Session: Poster Display session 3
Resources:
Abstract
2306 - Multiplex Chromogenic Immunohistochemistry (IHC) for Spatial Analysis of Checkpoint-Positive Tumor Infiltrating Lymphocytes (TILs)
Presenter: Scott Ely
Session: Poster Display session 3
Resources:
Abstract
1678 - The role of PD-L1 expression as a predictive biomarker in advanced renal cell carcinoma: a meta-analysis of randomized clinical trials.
Presenter: Alberto Carretero-Gonzalez
Session: Poster Display session 3
Resources:
Abstract
5138 - Radiomic Features as a Non-invasive Biomarker to Predict Response to Immunotherapy in Recurrent or Metastatic Urothelial Carcinoma
Presenter: Kye Jin Park
Session: Poster Display session 3
Resources:
Abstract
5800 - Integrative combination of high-plex digital profiling techniques and cluster analysis to reveal complex immune biology in the tumor microenvironment of mesothelioma
Presenter: Carmen Ballesteros-Merino
Session: Poster Display session 3
Resources:
Abstract
5736 - Predictive factors of response to immunotherapy in 198 patients with metastatic non-microcytic lung cancer (mNSCLC): real world data from 2 university hospitals in Spain
Presenter: Juan Felipe Cordoba Ortega
Session: Poster Display session 3
Resources:
Abstract
5645 - Evaluating Lung CT Density Changes Among Patients with Extensive Stage Small Cell Lung Cancer (ES-SCLC) Treated with Thoracic Radiotherapy (TRT) alone or TRT Followed by Combined Ipilimumab (IPI) and Nivolumab (NIVO).
Presenter: Kujtim Latifi
Session: Poster Display session 3
Resources:
Abstract
1540 - Immuno-oncology therapy biomarkers differences between polyoma-virus positive and negative Merkel cell carcinomas
Presenter: Zoran Gatalica
Session: Poster Display session 3
Resources:
Abstract
4538 - Can we improve patient selection for phase 1 clinical trials (Ph1) based on Immuno-Oncology score prognostic index (VIO)?
Presenter: Ignacio Matos Garcia
Session: Poster Display session 3
Resources:
Abstract