OncoSEGUE: Transforming cancer care delivery through a decentralized, community-integrated oncology model in Southern Portugal.

Abstract

e13536 Background: Geographic dispersion, limited oncology capacity, and heavy dependence on medical transport pose major barriers to cancer care in the Algarve, Portugal. To address increasing incidence and long travel times, OncoSEGUE was established as a decentralized, community-integrated oncology program delivering consultations, systemic treatments, and supportive care directly within primary care centers across five municipalities. Methods: A mobile multidisciplinary team (oncologist, nurse, pharmacist, phlebotomist) conducted weekly or biweekly sessions in Lagos, Aljezur, Vila do Bispo, Monchique, and Silves. Eligible patients included those in follow-up or receiving oral, IV, or palliative treatment. Clinical activity, transport-related expenditures, and patient-reported experience were collected from SONHO v2 and structured questionnaires. Results: From September 2024 to September 2025, the program delivered 1,290 medical consultations, 596 nursing consultations, 779 pharmaceutical consultations, 603 treatment sessions, and 1,172 blood tests. These represented 33–41% of the Oncology Service’s overall activity increase. Transport expenditures fell by >50% (~€500,000). Patients reported marked improvements in convenience, reduced fatigue, shorter travel times (>4h to <1h), and fewer work absences. Over 85% rated overall satisfaction as “very high”; qualitative comments emphasized improved well-being, continuity, and trust. No compromise in treatment quality was identified. Conclusions: OncoSEGUE demonstrates that a decentralized oncology program can substantially improve access, efficiency, and patient experience while releasing hospital capacity and reducing system costs. Expansion to survivorship clinics, primary-care triage, broader blood-draw capacity, and palliative-care integration is planned.