title: IPOS Sutherland Memorial Lecture: psycho-oncology and health care research.
abstract: Remarkable changes of health-care systems, increasing costs of health care and of social inequality in modern societies, an aging population and the increase of chronic illnesses such as cancer implicate various future challenges for the provision of health care. Health-care research aims to improve the effectiveness and efficiency of patient-oriented services involving the evaluation of innovative treatment approaches and settings. It deals with the patients' path through different areas of health-care systems in order to identify significant factors for the provision of quality assurance of structures and resources concerning treatments, processes and health outcomes. Health-care research focusses on three main topics that play an important role for quality management: (1) the admission to health-care services and assessment strategies including indication, utilization and specificity of settings and target groups; (2) the treatment process including the implementation, standardization and flexibility of services and dose-effect relationship of interventions; (3) health-care outcome including effectiveness and efficiency of interventions and services, the cost-benefit relationship and the transfer from research to health-care practice. Given the objectives of health-care research, the topics of health-care research in psychosocial care for cancer patients include the study of structural conditions of psycho-oncological services, the epidemiology of distress and mental disorders and the subjective need of psycho-oncological support in cancer patients, the improvement of psycho-oncological measures and assessment strategies in daily treatment, the study of psycho-oncological interventions under routine conditions, and quality assurance. Requirements of future health-care research and developments of psycho-oncology including aspects of orientation, strategies, health-care equity, and resources are discussed.
authors.affiliation: Psycho-Oncology and Health Care Research, Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. koch@uke.uni-hamburg.de
authors.forename: Uwe
authors.initials: U
authors.lastname: Koch
mesh_terms: D003131:Combined Modality Therapy / Q000191:economics / Q000523:psychology; D015897:Comorbidity / Q000639:trends; D003362:Cost-Benefit Analysis / Q000639:trends; D004059:Diffusion of Innovation; D005544:Forecasting; D005858:Germany; D006284:Health Plan Implementation / Q000191:economics / Q000639:trends; D006302:Health Services Research / Q000191:economics / Q000639:trends*; D006801:Humans; D001523:Mental Disorders / Q000191:economics / Q000523:psychology / Q000534:rehabilitation; D009369:Neoplasms / Q000191:economics / Q000523:psychology* / Q000534:rehabilitation*; D010348:Patient Care Team / Q000191:economics / Q000639:trends; D011785:Quality Assurance, Health Care / Q000191:economics / Q000639:trends; D019984:Quality Indicators, Health Care / Q000191:economics / Q000639:trends; D012017:Referral and Consultation / Q000191:economics / Q000639:trends; D016896:Treatment Outcome