ZusammenfassungDie Corona-Pandemie hat nahezu alle Bereiche des Gesundheitswesens, aber gerade auch die Onkologie stark beeinflusst. Anhand unterschiedlicher Datenquellen werden die ambulante und stationäre Entwicklung onkologischer Fälle insgesamt sowie am Beispiel des Kolorektalen Karzinoms (KRK) die Auswirkungen der Pandemie auf diagnostische und therapeutische Maßnahmen retrospektiv untersucht.Von März 2020 bis Mai 2021 zeigen sich – in Abhängigkeit des Infektionsgeschehens – unterschiedlich starke Einbrüche bei den Fallzahlen. Diese betreffen die Krankenhäuser durchweg stärker als den vertragsärztlichen Bereich, beim KRK sind sie im Vergleich der Jahre 2020 mit 2019 sowohl in der Gesamtzahl (−10,27 %; −10,57 %) als auch bezogen auf die operative Tumorentfernung (−9,56 %; −10,52 %) stärker als in der Onkologie insgesamt (−5,86 %; −6,57 %). Diagnostische Koloskopien insgesamt haben im Jahresvergleich moderat abgenommen, wobei die Rückgänge im Krankenhausbereich (ambulant −14,18 % und stationär −15,74 %) deutlich stärker als im vertragsärztlichen Bereich (−2,47 %; −3,29 %) sind. Früherkennungskoloskopien haben 2020 im Vergleich zum Vorjahr sogar leicht zugenommen (+2,89 % bzw. +2,16 %).Trotz erschwerter Versorgungsbedingungen hat onkologische Versorgung während der Covid-19-Pandemie in einem beträchtlichen Ausmaß stattgefunden. Das deutsche Gesundheitswesen hat sich damit als leistungsfähig erwiesen. Perspektivisch müssen nicht hinreichend erklärbare Fallzahlrückgänge, insbesondere bei den operativen Fällen mit KRK, weiter untersucht werden.
<b><i>Introduction:</i></b> As part of the development of the evidence-based (S3) clinical practice guidelines for kidney and bladder cancer by the German Guideline Program in Oncology, quality indicators (QIs) were defined to measure the quality of care. Based on these guidelines and QIs, the German Cancer Society (DKG) developed two new certification systems. The aim of this article is to show the process of development and implementation of QIs in certified cancer centres. <b><i>Methods:</i></b> Based on strong recommendations of each guideline and an additional systematic literature review for national and international QIs, two sets of QIs were derived in a multistep standardized approach. These QIs were implemented in the centres in certification data sheets to measure their outcomes. First results of treatment years 2018 and 2019 are available. <b><i>Results:</i></b> The final sets include 9 QIs for kidney cancer and 12 QIs for bladder cancer. Two-thirds of the QIs were transferred to the data sheets. In 2018 and 2019, the results of all but one QI are within the plausibility limits. From 2020 on, they are replaced by stricter target values that will challenge centres to improve their outcomes. <b><i>Conclusions:</i></b> Guideline-derived QIs make relevant aspects of patient care measurable and consequently improvable. The first QI results are encouraging. However, the DKG certification system and the methods of measuring quality are under ongoing development. Systematic QI implementation and evaluation may help to generate broader databases and thus expand knowledge.
Introduction: Soft tissue sarcomas (STS) are rare diseases. A high level of standardization and centralisation was lacking in Germany until 2018. Methods: By developing an evidence-based guideline and a certification system for sarcoma centres, foundations for structured, guideline-based and centralised sarcoma care were defined. First results of the certified Sarcoma Centres are presented. Results: The first three years of data collection show good results for case volume, presentation rates in pretherapeutic and postoperative tumor boards, psychooncological counselling and study rates. However, other indicators (e.g. preoperative or postoperative radiotherapy for operated high risk STS without GIST, counselling rates social services) still have potential for improvement. Based on these results, the set of indicators could be further improved. Conclusions: A sarcoma-specific quality assurance scheme that includes guideline-derived quality indicators was developed. In future, a broader database will allow further insights into sarcoma care in Germany.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.