title: Continuity of care of cancer patients. Analysis of theoretical models and survey tools of continuity of care in people with a cancer diagnosis.
abstract: BACKGROUND
  The Italian Ministry of Health declared oncology a priority and stressed the importance of ensuring continuity and integration in cancer care pathways. In order to monitor the quality of cancer care pathways, we need to explore patients' experience of the continuity of care, identifying the dimensions that define continuity.
  
  
  METHODS
  We found 886 relevant articles in the Pubmed database from 1987 to 5 November 2013. The search strategy for the electronic database was defined using the Population, Intervention, Comparison and Outcome(s) framework (PICO) to identify keywords. Two researchers independently reviewed records identified through the search strategy, analyzing continuity dimensions, specificity and/or transversal domains.
  
  
  RESULTS
  We selected 20 articles that measure the patients' experience of continuity of care: 7 articles including 5 questionnaires [Questionnaire by King et al. 2008; Cancer care coordination Questionnaire (Cccq); Patient Continuity of Care Questionnaire (Pccq); Medical Care Questionnaire (Mcq); Continuity and Coordination of Care Questionnaire (CCCQ)]; 6 articles evaluating the relationship between patient and his/her physician (the same across the care pathway) in terms of frequency and/or dispersion; 6 articles considering one subscale of larger scales designed to evaluate the generic cancer care service patient experience; 1 revealing four organizational indicators of care pathway continuity / discontinuity.
  
  
  CONCLUSIONS
  We traced 3 transversal dimensions across the individual analyses: informational, organizational, relational continuity. It follows that in order to cater to the needs of cancer patients, we need to simultaneously focus on these three dimensions along the cancer care pathway. In line with these results, we promoted the "R.In.Cu.ORAM.i" study (Networks for Integrated Treatment of colorectal and breast cancer), in Area Vasta Romagna Area (Italy), and developed a continuity of care patient-experience continuity tool.
authors.affiliation: Local Health Authority of Romagna, Ravenna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Marcon
authors.affiliation: Local Health Authority of Romagna, Ravenna, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Bravi
authors.affiliation: Department of Biomedical and Neuro-motor Sciences, University of Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Foglino
authors.affiliation: National Agency for Regional Health Services (Age.na.s), Quality and Accreditation Area, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Angelastro
authors.affiliation: Department of Biomedical and Neuro-motor Sciences, University of Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Carretta
authors.affiliation: IRCCS Scientific Institute of Romagna for the Study and Treatment of Cancer (IRST IRCCS), Meldola (FC), Italy.
authors.forename: M P
authors.initials: MP
authors.lastname: Altini
authors.affiliation: Department of Biomedical and Neuro-motor Sciences, University of Bologna, Italy.
authors.forename: M P
authors.initials: MP
authors.lastname: Fantini
authors.affiliation: Emilia Romagna Region - Directorate General for Health and Social Policy, Bologna, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Carradori
mesh_terms: D003266:Continuity of Patient Care; D006801:Humans; D008962:Models, Theoretical; D009369:Neoplasms / Q000628:therapy*; D011795:Surveys and Questionnaires