A relational and geographic method for integrating cancer care pathways

The article supporting this method (Mériade & Rochette, 2020) examines how to apply a spatial approach including the geographical and relational dimensions to care pathways for their better integration within their territories. Based on the case study of a senology department of a French Cancer Diagnosis, Treatment and Research Center, we apply a mixed research methodology using qualitative data (synthesis documents, meeting minutes, in-depth interviews) and quantitative data relating to the mobility and geographical location of a cohort of 1798 patients treated in this center. The objective of this method is to combine, in a dynamic way, a relational and cartographic approach in order to describe integrated health care pathways in their territories. Our results show the inseparable nature of the relational dimension and the geographical approach to move towards greater integration of breast cancer care pathways. This inseparability is illustrated by an initial cartographic description of integrated care pathways in their territory, illustrated in our case study by four major pathway categories. This research provides answers to the difficulties observed by the health authorities in France concerning the implementation of coordinated patient pathways at the area level. • The first step of the method is to identify how pathway integration is expressed for professionals and patients. • The second step, continuing from the first, consists of observing the criteria for identifying the care pathways chosen by stakeholders (patients, healthcare institutions, city medicine). • The third step consists of representing, on a geographic map, the elements relative to the different criteria observed during the second step from the study of a cohort of patients.