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Title: Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS): Prospective cohort study protocol
Authors: Teo, I 
Singh, R
Malhotra, C 
Ozdemir, S 
Dent, R.A 
Kumarakulasinghe, N.B
Yeo, W.L
Cheung, Y.B 
Malhotra, R 
Kanesvaran, R 
Yee, A.C.P 
Chan, N 
Wu, H.Y
Chin, S.M
Allyn, H.Y.M
Yang, G.M 
Neo, P.S.H 
Nadkarni, N.V 
Harding, R
Finkelstein, E.A 
Keywords: adult
advanced cancer
cancer mortality
cancer prognosis
caregiver burden
cohort analysis
daily life activity
distress syndrome
functional status
health belief
health care cost
health care delivery
health care quality
health care utilization
medical care
medical decision making
metastatic breast cancer
patient participation
patient preference
physical well-being
prospective study
prostate cancer
public health service
quality of life
terminal care
tertiary health care
attitude to health
clinical protocol
critical illness
health survey
mental stress
middle aged
patient attitude
severity of illness index
young adult
Clinical Protocols
Critical Illness
Health Care Costs
Health Expenditures
Health Knowledge, Attitudes, Practice
Middle Aged
Patient Acceptance of Health Care
Public Health Surveillance
Quality of Life
Severity of Illness Index
Stress, Psychological
Young Adult
Issue Date: 2018
Citation: Teo, I, Singh, R, Malhotra, C, Ozdemir, S, Dent, R.A, Kumarakulasinghe, N.B, Yeo, W.L, Cheung, Y.B, Malhotra, R, Kanesvaran, R, Yee, A.C.P, Chan, N, Wu, H.Y, Chin, S.M, Allyn, H.Y.M, Yang, G.M, Neo, P.S.H, Nadkarni, N.V, Harding, R, Finkelstein, E.A (2018). Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS): Prospective cohort study protocol. BMC Cancer 18 (1) : 459. ScholarBank@NUS Repository.
Abstract: Background: Advanced cancer significantly impacts quality of life of patients and families as they cope with symptom burden, treatment decision-making, uncertainty and costs of treatment. In Singapore, information about the experiences of advanced cancer patients and families and the financial cost they incur for end-of-life care is lacking. Understanding of this information is needed to inform practice and policy to ensure continuity and affordability of care at the end of life. The primary objectives of the Cost of Medical Care of Patients with Advanced Serious Illness in Singapore (COMPASS) cohort study are to describe changes in quality of life and to quantify healthcare utilization and costs of patients with advanced cancer at the end of life. Secondary objectives are to investigate patient and caregiver preferences for diagnostic and prognostic information, preferences for end-of-life care, caregiver burden and perceived quality of care and to explore how these change as illness progresses and finally to measure bereavement adjustment. The purpose of this paper is to present the COMPASS protocol in order to promote scientific transparency. Methods: This cohort study recruits advanced cancer patients (n = 600) from outpatient medical oncology clinics at two public tertiary healthcare institutions in Singapore. Patients and their primary informal caregiver are surveyed every 3 months until patients' death; caregivers are followed until 6 months post patient death. Patient medical and billing records are obtained and merged with patient survey data. The treating medical oncologists of participating patients are surveyed to obtain their beliefs regarding care delivery for the patient. Discussion: The study will allow combination of self-report, medical, and cost data from various sources to present a comprehensive picture of the end-of-life experience of advanced cancer patients in a unique Asian setting. This study is responsive to Singapore's National Strategy for Palliative Care which aims to identify opportunities to meet the growing need for high quality care for Singapore's aging population. Results will also be of interest to policy makers and researchers beyond Singapore who are interested to understand and improve the end-of-life experience of cancer patients. © 2018 The Author(s).
Source Title: BMC Cancer
ISSN: 1471-2407
DOI: 10.1186/s12885-018-4356-z
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