Introduction: Due to its high incidence, evaluating performance of care delivered to breast cancer patients is a crucial issue. The multidisciplinary panel E.Pic.A. (Economic Appropriateness of an Integrated Care Pathway) defined a set of key performance indexes (KPIs) to evaluate economic waste in breast cancer healthcare interventions. Methods: The E.Pic.A. panel identified the principal KPIs that are crucial within the breast cancer care pathway to evaluate the performance of care. KPIs were defined taking into account their reliability, validity, usability and feasibility of measurement through the linkage between multiple routine healthcare data sources. Results: 7 KPIs were identified: 3 on instrumental diagnostics, 2 on surgery and 2 on treatment. The 3 KPIs regarding instrumental diagnostics are aimed at assessing the inappropriateness of diagnostic tests performed before and after the index surgery. The 2 KPIs regarding surgery measure the inappropriateness of possible repeated interventions considering the time elapsed from the index surgery. The 2 KPIs regarding oncologic therapy measure the inappropriateness about the administration time of adjuvant therapy and radiotherapy considering the time elapsed from the index surgery. Conclusion: E.Pic.A methodology could help to evaluate economic waste in healthcare interventions with the objective of redirecting resources to interventions with greater value.
A519 days; In KPI5 58% of patients received adjuvant chemotherapy within 60 days after surgery; In KPI6 57% of patients performed radiotherapy within 90 days after surgery (who did not receive adjuvant chemotherapy) and 69% within 180 days after surgery (who received adjuvant chemotherapy); In KPI7 74% of the patients with tumor stage I and II performed one diagnostic examinations within 365 months after surgery. ConClusions: This study sustains the replicability of E.Pic.A. in different realities, the use of the KPIs to measure the performance is a way to guarantee a homogenous level of care regardless where the treatment is performed. Potentially, the improvement of these KPIs could lead to cost savings coming from inefficiencies that could be relocated to higher-value interventions for patients. References: 1. Massa et al., The Breast 34 (2017) 103-107. Disease-specific stuDies inDiviDual's HealtH-clinical Outcomes studies piH1 cOmparing tHe effect Of prOgressive relaxatiOn anD perineal strengHtening interval exercises amOng WOmen WitH primaer DysmenOrrHOea tO reDuce menstrual cramps
Background: Given limitations in economic resources, achieving sustainability in healthcare is an increasingly important issue driving policy decisions. Colorectal cancer (CRC) is a frequent oncological diagnosis with an incidence that is expected to increase, making the efficient utilisation of resources a major priority for its diagnosis and treatment. To assess potentially inappropriate utilisation of services in the integrated care pathway of patients with malignant CRC, a series of key performance indicators (KPIs) have been developed by a multidisciplinary panel of the E.Pic.A. project (Economic Appropriateness of an Integrated Care Pathway).Methods: The KPIs identified had to comply with criteria of reliability, representativeness, accessibility and operativity. A definition is provided for each of the KPIs, along with the methodology used to calculate it and a reference target.Results: Eight KPIs were identified that can measure inadequacies of services provided in the diagnostic and treatment pathways for CRC: four for instrumental diagnostics, three for surgery and one for oncologic therapy.Conclusions: Use of the methodology described can help payors to obtain detailed information on inappropriate and wasteful use of healthcare resources, which would then permit their reallocation for interventions with higher value for patients with CRC and other pathologies. (HTA & Market Access, Oncology)
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