Evaluating the effect of clinical care pathways on quality of cancer care: analysis of breast, colon and rectal cancer pathways

Han, Baohui; Yang, Fengjuan; Su, Shaofei; Wang, Xinyu; Zhang, Meiqi; Xiao, Yaming; Jiang, Hao; Wang, Jiaying; Liu, Meina

doi:10.1007/s00432-015-2106-z

Cited by 28 publications

(20 citation statements)

References 30 publications

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“…This finding indicated that the time efficiency of treating similar diseases in medical institutions in Henan Province was worse than that in institutions in Beijing, but it had improved yearly, particularly in patients who underwent surgery. This finding may be associated with the implementation of clinical pathways [33,34]. The CEI of all enrolled breast cancer patients was less than 1 between 2016 and 2019, while that of JR15 (breast malignancy without complications or comorbidities), JA15 (total mastectomy without complications or comorbidities), and JA13 (total mastectomy with general complications or comorbidities) increased slowly yearly from 2016 to 2019.…”

Section: Results 1 Sample Characteristicsmentioning

confidence: 99%

DRGs-based health system performance for breast cancer patients

Liu

Wang

et al. 2020

Preprint

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Background: To evaluate health system performance for patients with breast cancer in Henan Province, China, using Diagnosis-Related Groups (DRGs) indicators and provide data to inform practices and policies for the prevention and control of breast cancer. Methods:The data were collected from the front pages of the medical records (FPMR) of all hospitals above class II that admitted breast cancer patients in Henan Province between 2016 and 2019. Breast cancer patients were the subjects in our study. China DRGs (CN-DRGs) were used as a risk adjustment tool. Three indicators, including the Case-Mix Index (CMI), number of DRGs, and total weight, were used to evaluate the range of available services for patients with breast cancer, while indicators including the Charge Efficiency Index (CEI), Time Efficiency Index (TEI) and inpatient mortality of lowrisk group cases (IMLRG) were used to evaluate the medical service efficiency and medical safety.Results: Between 2016 and 2019, there were 103,760 cases of patients with breast cancer. The number of enrolled patients and total weight increased over the study period at an average annual rate of 21.38% and 21.88%, respectively. The TEI decreased over the study period by 15.60%. The CEI exhibited an increasing trend, but the average annual rate of increase was small (2.94%). The IMLRP was 0.02%, 0%, 0% and 0.01% in 2016, 2017, 2018 and 2019, respectively. Conclusion:The health system performance improved between 2016 and 2019 for breast cancer patients discharged from the study hospitals in Henan Province. The main areas of improvement were in the range of available services, but medical institutions must still make efforts to improve the efficiency of medical services and ensure medical safety. DRGs are an effective evaluation tool. BackgroundBreast cancer is the most common malignancy in women, and approximately 11% of breast cancer cases worldwide occur in China [1]. Approximately 169,000 new female breast cancer patients are diagnosed annually, and this number has increased over the past forty years [2]. Henan Province has a large population with health outcomes at or below the national average [3]. The incidence of breast cancer in Henan Province is more than 35/100,000 [4]. While health system performance evaluation for breast cancer patients has the potential to improve clinical practices, the key activity rests in the Accreditation of Healthcare Organizations ; KPI :

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Section: Results 1 Sample Characteristicsmentioning

confidence: 99%

DRGs-based health system performance for breast cancer patients

Liu

Wang

et al. 2020

Preprint

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“…These studies represented 1,494 patients. The evidence base of pathway interventions in two studies remained "not sure", these studies are pending review because the authors did not reply to our emails and phone calls [19,25].…”

Section: Intervention Characteristicsmentioning

confidence: 99%

Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis

Hoeve

Vernooij

Fiander

et al. 2020

Preprint

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Background: Pathways are frequently used to improve care for cancer patients. However, there is little evidence about the effects of pathways used in oncological care. Therefore, we performed a systematic review and meta-analysis aiming to identify, and synthesise existing literature on the effects of pathways in oncological care. Methods: All patients diagnosed with cancer in primary and secondary/tertiary care whose treatment can be characterized as the strategy “care pathways” are included in this review. A systematic search in seven databases was conducted to gather evidence. Studies were screened by two independent reviewers. Study outcomes regarding patients, professionals and system level were extracted from each study. Results: Out of 13,847 search results, we selected 158 articles eligible for full text assessment. 150 studies were excluded and the remaining eight studies represented 4,786 patients. Most studies were conducted in secondary/tertiary care. LOS was the most common used indicator, and was reported in five studies. Meta-analysis based on subgroups showed an overall shorter Length of Stay (LOS) regarding gastric cancer (Weighted Mean Difference (WMD)): -2.75, CI: -4.67–-0.83) and gynaecological cancer (WMD: -1.58, CI: -2.10–-1.05). Costs were reported in six studies and most studies reported lower costs for pathway groups. Conclusions: Despite the differences between the included studies, we were able to present an evidence base for cancer care pathways performed in secondary/tertiary care regarding the positive effects of LOS in favour of cancer care pathways. Systematic review registration: PROSPERO CRD42017057592

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“…The majority of the included studies (nine studies) were conducted in the setting of secondary healthcare, within hospitals or in oncology centres [19][20][21][22][23][24][25][26][27]. These studies represented 1,494 patients.…”

Section: Intervention Characteristicsmentioning

confidence: 99%

“…The evidence base of pathway interventions in two studies remained "not sure", these studies are pending review because the authors did not reply to our emails and phone calls [19,25].…”

Section: Intervention Characteristicsmentioning

confidence: 99%

Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis

Hoeve

Vernooij

Fiander

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Pathways are frequently used to improve care for cancer patients. However, there is little evidence about the effects of pathways used in oncological care. Therefore, we performed a systematic review and meta-analysis aiming to identify, and synthesise existing literature on the effects of pathways in oncological care. Methods All patients diagnosed with cancer in primary and secondary care whose treatment can be characterized as the strategy “care pathways” are included in this review. A systematic search in seven databases was conducted to gather evidence. Studies were screened by two independent reviewers. Study outcomes regarding “patient outcomes” and “costs” were extracted from each study. Results Out of 12,689 search results, we selected 158 articles eligible for full text assessment. The remaining 10 studies represented 4,786 patients. Most studies were conducted in secondary care. LOS was the most common used indicator for patients outcomes, and was reported in five studies. Meta-analysis based on subgroups showed an overall shorter LOS regarding gastric cancer (WMD: -2.75, CI: -4.67–-0.83) and gynaecological cancer (WMD: -1.58, CI: -2.10–-1.05). Costs were reported in six studies and most studies reported lower costs for pathway groups. Conclusions Despite the differences between the included studies, we were able to present an evidence base for cancer care pathways performed in secondary care regarding the positive effects of LOS in favour of cancer care pathways.

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Evaluating the effect of clinical care pathways on quality of cancer care: analysis of breast, colon and rectal cancer pathways

Abstract: Clinical pathways can improve compliance with standard care by implementing evidence-based quality indicators in daily practice, which could serve as a useful tool for narrowing the gap between clinical practice and evidence-based care.

Cited by 28 publications

References 30 publications

DRGs-based health system performance for breast cancer patients

DRGs-based health system performance for breast cancer patients

Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis

Effects of oncological care pathways in primary and secondary care on patient, professional and health systems outcomes: a systematic review and meta-analysis

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