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Development of a national health policy logic model to accelerate the integration of oncology and palliative care: a nationwide Delphi survey in Japan

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Abstract

Background

Despite recommendations to deliver palliative care to cancer patients and their caregivers, their distress has not been alleviated satisfactorily. National health policies play a pivotal role in achieving a comprehensive range of quality palliative care delivery for the public. However, there is no standardised logic model to appraise the efficacy of these policies. This study aimed to develop a logic model of a national health policy to deliver cancer palliative care and to reach consensus towards specific policy proposals.

Methods

A draft version of the logic model and specific policy proposals were formulated by the research team and the internal expert panel, and the independent external expert panel evaluated the policy proposals based on the Delphi survey to reach consensus.

Results

The logic model was divided into three major conceptual categories: ‘care-delivery at cancer hospitals’, ‘community care coordination’, and ‘social awareness of palliative care’. There were 18 and 45 major and minor policy proposals, which were categorised into four groups: requirement of government-designated cancer hospitals; financial support; Basic Plan to Promote Cancer Control Programs; and others. These policy proposals were independently evaluated by 64 external experts and the first to third Delphi round response rates were 96.9–98.4%. Finally, 47 policy proposals reached consensus. The priority of each proposal was evaluated within the four policy groups.

Conclusions

A national health policy logic model was developed to accelerate the provision of cancer palliative care. Further research is warranted to verify the study design to investigate the efficacy of the logic model.

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Acknowledgements

We would like to thank all the Delphi panel members (Akira Yoshioka, Asami Wada, Atsushi Sato, Ayumi Okizaki, Chiharu Hamamoto, Chikako Shimizu, Eisuke Suzuki, Emi Ryu, Fumihiro Yamadera, Fumiko Yamada, Fumiyoshi Kumagai, Harue Arao, Haruto Ikeyama, Hidehito Tamura, Hideki Ueno, Hideyuki Kashiwagi, Hina Uetake, Hiromi Uehara, Hisashi Nakahashi, Hisashi Suyama, Hisateru Yasui, Ikuko Kazama, Jun Hamano, Kaori Takeuchi, Keiichi Uemura, Keiko Eguchi, Keiko Tamura, Ken Kaneko, Kikuko Kanno, Kimiko Nakano, Mayumi Noda, Midori Kawaguchi, Natsu Kato, Natsuko Okita, Nobuhisa Nakajima, Noriaki Hidaka, Noriya Koshida, Osamu Okamura, Rie Sasaki, Ryo Yamamoto, Sachiko Shimizu, Satofumi Shimoyama, Satoko Miyawaki, Satoko Tamura, Satoshi Miyake, Shigeru Tanda, Shihoko Yokokawa, Shosuke Kita, Susumu Iwamoto, Takako Ohta, Takashi Muramoto, Takashi Sakugawa, Tatsuo Akechi, Tatsuya Suzuki, Toru Tanaka, Toshimi Takano, Wakako Nishimura, Yayoi Ando, Yoichi Nakamura, Yoichi Shimizu, Yoko Kasahara, Yoshiaki Okamoto, Yuichi Shinada and Yuya Ise) for their insightful input. Moreover, we would like to thank the pilot survey participants for their helpful feedback in advance of the Delphi survey (Izumi Hayashida, Kiyofumi Oya, Masako Takagishi, Masami Kusuhara, Shoko Tsuji, Yuki Kawano, Yusuke Hiratsuka, Yusuke Kanno, and other people who wish to remain anonymous). We would like to express our gratitude to Dr. Masashi Kato and Professor Kenichi Hanioka for their contributions in planning and conducting this research.

Funding

This work was supported by the Ministry of Health, Labour and Welfare of Japan (Health Labor Science Research Grant: Grant No. 20EA1009). The funder had no role in the conception and/or design of the work, the acquisition, analysis, interpretation of data and/or the drafting of this manuscript.

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All authors made substantial contributions to the manuscript, including to the conception (YU, MI, NM, KT, YM, JN, TK, TS, MY, AM, IS, KM, MI, AY, TM, AI, MM) and design (YU, MI, NM, KT, YM, JN, TK, TM) of the study, to the literature search (YU, MI, NM, KT, YM, JN, TK), collection of the data (YU, MI, NM, KT, YM, JN, TK, TS, MY, AM, IS, KM, MI, AY, AI), and to the draft and final revision of the manuscript (YU, MI, NM, KT, YM, JN, TK, TS, MY, AM, IS, KM, MI, AY, TM, AI, MM). All authors provided final approval of the final version and its submission.

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Correspondence to Akira Inoue.

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All expert panel members in this study participated after written informed consent was obtained. This study was reviewed and approved by the Ethics Committee at the Kyoto University Graduate School and Faculty of Medicine, Kyoto University Hospital, based on the national ethical guidelines of epidemiological studies in Japan (Approval Number: R2958).

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Uneno, Y., Iwai, M., Morikawa, N. et al. Development of a national health policy logic model to accelerate the integration of oncology and palliative care: a nationwide Delphi survey in Japan. Int J Clin Oncol 27, 1529–1542 (2022). https://doi.org/10.1007/s10147-022-02201-0

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