Benchmarking the quality of breast cancer care in a nationwide voluntary system: the first five-year results (2003–2007) from Germany as a proof of concept

Brucker, Sara Y.; Schumacher, Claudia; Sohn, C; Rezai, Mahdi; Bamberg, M.; Wallwiener, D.

doi:10.1186/1471-2407-8-358

Cited by 60 publications

(63 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Initial data from Germany show that certified centers can achieve this, however. In a prospective multicenter study, Brucker et al [19] introduced a national benchmarking system for specialized breast centers. In the period between 2003 and 2007, there was clear optimization of the defined quality indicators -e.g., preoperative diagnostic confirmation with punch biopsy or radiotherapy after BCT.…”

Section: The Effectiveness Side Of Certified Breast Centersmentioning

confidence: 99%

Are Certified Breast Centers Cost-Effective?

Beckmann¹,

Bani²,

Loehberg³

et al. 2009

Breast Care

View full text Add to dashboard Cite

The German health care system has entered an era of specialist centers and certification. Hospitals are required to introduce quality management with external monitoring, refining and improving their quality of treatment. These statutory requirements can only be met through specialization, centralization, and establishing centers and networks with internal and external interdisciplinary collaboration. The breast centers certified according to the criteria of the German Cancer Society (DKG) and German Society for Mastology (DGS) are pioneers here. Simultaneously, there are increasing demands for more cost-effective medical services despite limited resources – making economic analysis of health care provision necessary. Few economic studies of the centers and certification system have been conducted, however. General long-term quality data, particularly for results, are not yet available from certified breast centers. At present, a certified breast center is not itself a proven independent prognostic parameter for treatment results. However, the individual criteria required for breast center certification show a significant positive influence on clinical efficacy. Certified breast centers involve substantial extra costs that are not reimbursed by funding bodies, so the slightest potential benefit for patients from certified centers already appears cost-effective. When the actual costs, currently usually subsidized by other departments, are considered, it is unclear whether certified breast centers remain cost-effective.

show abstract

Section: The Effectiveness Side Of Certified Breast Centersmentioning

confidence: 99%

Are Certified Breast Centers Cost-Effective?

Beckmann¹,

Bani²,

Loehberg³

et al. 2009

Breast Care

View full text Add to dashboard Cite

show abstract

“…Up to now, there is very little proof that the efforts truly result in an improved survival or quality of life for breast cancer patients. A reasonable amount of data has been accumulated on the quality indicators that must be interpreted as surrogate markers for the ultimate aims of survival and quality of life [12]. Some of the quality indicators have been linked to improved survival such as the number of breast cancer cases treated per hospital (reviewed by Scharl and Gohring [13]).…”

Section: Introductionmentioning

confidence: 99%

Quality Assured Health Care in Certified Breast Centers and Improvement of the Prognosis of Breast Cancer Patients

et al. 2011

View full text Add to dashboard Cite

Background: Increasing effort has been put in the implementation and certification of breast centers in order to establish standardized, quality assured health care for breast cancer patients. The aim of this analysis was to investigate whether patients treated in certified breast centers (CBC) have a favorable prognosis as compared to patients treated outside of certified breast treatment units. Patients and Methods: The data of 3,940 patients with invasive nonmetastatic breast cancer were analyzed with regard to differences in patient and tumor characteristics and crude overall survival according to diagnosis in or outside CBC in Middle Franconia, Germany. Patient, tumor, and follow-up data were obtained from the clinical cancer registry. Results: Patients in CBC were younger, and had lower disease stages and lower grading. Independent of the effects of these variables on overall survival, being treated at a CBC added to the prediction of overall survival. Patients treated at a CBC had a hazard ratio of 0.70 (95% confidence interval 0.52–0.93) in the adjusted Cox model. Conclusions: Independent from common prognostic factors, diagnosis and treatment of breast cancer at a CBC improves the prognosis of patients. It can be hypothesized that this effect is mediated through quality assured health care provided by the certification process.

show abstract

“…Evidence-basedmedicine(EBM)criteriastipulatethatclinically andmethodologicallyrelevantstudiesbeselectedbeforethe consensus process is applied to the extracted results, which thenleadstotheformulationoftheappropriaterecommendationsandstatements [6][7][8][9].TheoriginalS3guidelineonthe treatmentofbreastcancerandthefirstupdateissuedin2008 werefoundedonthecurrentlybestavailableevidence,which wasbasedonmethodologicallyhigh-qualitystudies. Althoughthesehighstandardswereconsideredtodevelop the S3 guidelines, it is not enough to just implement guidelines.Ithastobeverifiedthattheimplementationdoesresult intheexpectedimprovementofbreastcancercare.Although thebenefitofaguidelinehasbeenassumedandiswidelyaccepted [10], detailed investigations of its real profit for the breastcancerpatientshavebeenneglectedsofar.…”

Section: Introductionmentioning

confidence: 99%

Impact of Guideline Conformity on Breast Cancer Therapy: Results of a 13-Year Retrospective Cohort Study

et al. 2010

View full text Add to dashboard Cite

Background: To date, few studies have investigated whether the implementation of national breast cancer guidelines fulfills the goal to optimize the national standard of care. Therefore, we aimed to evaluate retrospectively the guideline-related 13-year data on breast cancer patients treated at our institution. Patients and Methods: In a retrospective cohort study, the records of a total of 2,231 patients with primary breast cancer treated during the period of 1992–2005 at the Department of Obstetrics and Gynecology, University of Ulm, Germany, were analyzed. Based on the German national Step 3 (S3) guideline, a model was created to classify groups according to therapy ‘conforming’ and ‘non-conforming’ to guideline recommendations. Results: In 2005, 70.2% of all patients included received both surgical and systemic adjuvant therapies conforming to the guideline. Guideline-conforming treatment was accompanied with significant advantages in terms of recurrence-free survival (RFS) and overall survival (OAS) rates. Conclusions: It has to be demanded that breast cancer patients are treated in con-formity with the S3 guidelines. The reasons for a treatment not conforming to the guidelines should be analyzed for the detection of barrier factors, in order to optimize adherence to the guidelines and therefore to prolong RFS and OAS.

show abstract

Benchmarking the quality of breast cancer care in a nationwide voluntary system: the first five-year results (2003–2007) from Germany as a proof of concept

Cited by 60 publications

References 7 publications

Are Certified Breast Centers Cost-Effective?

Are Certified Breast Centers Cost-Effective?

Quality Assured Health Care in Certified Breast Centers and Improvement of the Prognosis of Breast Cancer Patients

Impact of Guideline Conformity on Breast Cancer Therapy: Results of a 13-Year Retrospective Cohort Study

Contact Info

Product

Resources

About