Patient-centred multi-professional cancer care: evidence from clinical practice and managerial implications

Cancer patients require comprehensive and integrated care along the diagnostic and therapeutic pathway, and the gradual increase in survival makes cancer increasingly resemble chronic diseases. Healthcare systems have evolved into care pathway models that provide patient-centred, multidisciplinary and transversal care to chronic patients. The care of cancer has thus evolved in a more integrated care provision, approaching a collaborative, coordinated and cross-disciplinary shape in patient management. However, collaborative cancer care appears limited, and challenged by numerous issues at team, provider, system and patient level. Defining proper performance indicators and implementing tailored performance management strategies is imperative to support multi-professional practices in improving patient management and outcomes. The main research question of the thesis is to assess and provide evidence on patient-centred multi-professional cancer care adopting a multidimensional evaluation approach, including cost-effectiveness, professional perspectives on care delivery and the engagement of professionals in performance management. The methods adopted show the potential of replicability for the management of other chronic non-cancer diseases and care pathways involving a plurality of professionals and shaped by the intrinsic marked complexity of healthcare networks.