Impact of quality certification of multidisciplinary head and neck tumor centers

Abstract

Background Certification of multidisciplinary tumor centers is nowadays seen as the gold standard in modern oncological therapy for optimization and realization of guideline-based therapy and better outcomes. Single cases are reimbursed based on diagnosis-related groups (DRG). We aimed to review efficiency, cost analysis, and profitability following a certification. Methods Tumor board certification at the university hospital Aachen was implemented in 2013. We compared 1251 cases of oropharyngeal cancer treated from 2008 to 2017 before and after certification. For this purpose, several patient characteristics, surgery, and stay-related constants, as well as expenses and reimbursement heights were analyzed statistically. Results Following certification, the total case and patient number, surgery duration, hours of mechanical ventilation, case mix index points, DRG reimbursements as well as the costs increased significantly, whereas days of intensive care unit, amount of blood transfusions, patient clinical complexity level (PCCL) and the overall stay were significantly lowered. No changes were observed for the patient’s age and gender distribution. Also, the predetermined stay duration stayed constant. Conclusions Certification of head-neck tumor centers causes a concentration of more complex cases requiring higher surgical efforts, which can be processed more efficiently due to a higher level of professionalism. Despite their benefits in cancer care, without compensation, centers may be struggling to cover their expenses in a system, which continuously underestimates them.

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“…In diesem Jahr feiert die Deutsche Krebsgesell- (Beckmann et al 2011;Butea-Bocu et al 2021;Cheng et al 2021;Diers et al 2021;Greger et al 2018;Haj et al 2017;Hoffmann et al 2018;Jacob et al 2021;Modabber et al 2021 In die Therapiepläne sind die leitlinienentsprechenden Antiemetika aufzunehmen. Im speziellen bei hoch-emetogenen/moderat-emetogenen Therapien soll die leitliniengerechte antiemetische Prophylaxe und Therapie in den Therapieplan aufgenommen werden: http://www.leitlinienprogramm-onkologie.de/leitlinien/ supportive-therapie/, Tab.…”

Digital decision support for structural improvement of melanoma tumor boards: using standard cases to optimize workflow

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