Cancer in The Netherlands. From scenarios to health policy

Using the scenario method in the context of health and health care--a scoping review

Background

The scenario technique is a method for future research and for strategic planning. Today, it includes both qualitative and quantitative elements. The aims of this scoping review are to give an overview of the application of the scenario method in the fields of health care and to make suggestions for better reporting in future scenario projects.

Methods

Between January 2013 and October 2013 we conducted a systematic search in the databases Medline, Embase, PsycInfo, Eric, The Cochrane Library, Scopus, Web of Science, and Cinahl since inception for the term ‘scenario(s)’ in combination with other terms, e.g. method, model, and technique. Our search was not restricted by date or language. In addition, we screened the reference lists of the included articles.

Results

A total of 576 bibliographical records were screened. After removing duplicates and three rounds of screening, 41 articles covering 38 different scenario projects were included for the final analysis. Nine of the included articles addressed disease related issues, led by mental health and dementia (n = 4), and followed by cancer (n = 3). Five scenario projects focused on public health issues at an organizational level and five focused on the labor market for different health care professionals. In addition, four projects dealt with health care ‘in general’, four with the field of biotechnology and personalized medicine, and additional four with other technology developments. Some of the scenario projects suffered from poor reporting of methodological aspects.

Conclusions

Despite its potential, use of the scenario method seems to be published rarely in comparison to other methods such as the Delphi-technique, at least in the field of health care. This might be due to the complexity of the methodological approach. Individual project methods and activities vary widely and are poorly reported. Improved criteria are required for reporting of scenario project methods. With improved standards and greater transparency, the scenario method will be a good tool for scientific health care planning and strategic decision-making in public health.

Electronic supplementary material

The online version of this article (doi:10.1186/s12874-015-0083-1) contains supplementary material, which is available to authorized users.

Factors relating to terminally ill cancer patients' willingness to continue living at home during the early phase of home care after discharge from clinical cancer centers in Japan

Objective: To assess the willingness of Japanese terminally ill cancer patients to continue living at home during the early phase of home care after discharge from a Clinical Cancer Center (CCC) in Japan, and to identify factors relating to their willingness to continue living at home.

Methods: A cross-sectional questionnaire survey of a convenient sample of both Japanese terminally ill cancer patients and their caregivers (PFCs) was conducted (n = 294, effective response rate 25.0%). Questionnaires were mailed and medical records were accessed for 73 pairs of respondents, comprising one terminally ill cancer patient and one PFC.

Results: At about 10 days after discharge, 64 patients (88%) wished to continue living at home. A hierarchical logistic regression analysis was performed on the data. It was found that the fewer the medical treatments undergone (OR = 0.20, 95% CI: 0.05–0.72), the higher the patients' perception that their condition was consistent with care at home (OR = 2.77, 95% CI: 1.08–8.62) and with their functional well-being (OR = 1.45, 95% CI: 1.08–2.17). In addition, the higher the caregivers' satisfaction with life (OR = 2.37, 95% CI: 1.15–5.77), the more willing patients tended to be to continue living at home.

Significant of results: The willingness of Japanese terminally ill cancer patients to continue living at home appears to be affected by caregiver status. This indicates a need for discharging facilities to monitor the state of home assistance and to investigate the nature of assistance required for continuing home care.

The future cancer burden as a study subject

The various purposes of predictions of future cancer burden are outlined and divided principally into two contexts, administrative and scientific. Various difficulties in making predictions are reviewed, relating to unknown etiology of cancer, to changes in definitions, criteria and facilities, to weaknesses in the statistical base and to choice of the statistical model. Predictions made under the Nordic Action Plan against Cancer, particularly for Sweden, are given as an example. The other examples concern predictions of incidence of lung cancer and smoking in Europe and incidence of breast cancer and mammography screening in Finland.