Implementation of a clinical pathway in breast cancer patients undergoing breast surgery

Taştan, Sevinç; Hatipoğlu, Sevgi; İyigün, Emine; Kılıç, Selim

doi:10.1016/j.ejon.2011.07.003

Cited by 21 publications

(55 citation statements)

References 15 publications

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“…The speci c interventions regarding the pathways described in the included studies, showed considerable variation. In three studies a description of the pathway as well as a gure of the pathway was provided [20,23,26]. In six studies the care pathway focused on the perioperative phase in order to guide surgical management [20][21][22][23][24]26].…”

Section: Intervention Characteristicsmentioning

confidence: 99%

“…In three studies a description of the pathway as well as a gure of the pathway was provided [20,23,26]. In six studies the care pathway focused on the perioperative phase in order to guide surgical management [20][21][22][23][24]26]. One study presented a pathway for the hospital staff as well as a pathway for patients [23].…”

Section: Intervention Characteristicsmentioning

confidence: 99%

“…In three studies a non-randomized controlled trial study design was applied [20,23,26]. In these studies patients in the nonpathway group received general care, and simultaneously patient in the pathway group were managed based on the pathway.…”

Section: Non-randomized Controlled Trialsmentioning

confidence: 99%

“…Three studies were conducted in general and non-academic hospitals or oncology centres [24,26,27]. Other studies were performed in an academic hospital [20,21,22].…”

Section: Settingmentioning

confidence: 99%

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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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Section: Intervention Characteristicsmentioning

confidence: 99%

Section: Intervention Characteristicsmentioning

confidence: 99%

Section: Non-randomized Controlled Trialsmentioning

confidence: 99%

“…Three studies were conducted in general and non-academic hospitals or oncology centres [24,26,27]. Other studies were performed in an academic hospital [20,21,22].…”

Section: Settingmentioning

confidence: 99%

See 2 more Smart Citations

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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“…Clinical pathways can then be used as a tool to standardize processes and improve quality of care, as previously conducted in other fields of medicine: congestive heart failure, stroke, asthma, or deep vein thrombosis [3][4][5][6]. Most studies on BC care pathways have focused on a specific phase of treatment, such as surgery [7,8] or radiotherapy [9] and few studies have assessed the complete and global care pathway of early BC patients, including treatment, support and innovative organizations, such as the use of outpatient surgery.…”

Section: Introductionmentioning

confidence: 99%

Direct medical and non-medical costs of a one-year care pathway for early breast cancer: results of a French multicenter prospective study

Héquet

Huchon

Soilly

et al. 2019

Preprint

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Introduction: The organization of health care for breast (BC) constitutes a public health challenge to ensure quality of care, while also controlling expenditure. Few studies have assessed the global care pathway of early BC patients, including a description of direct medical costs and their determinants.Methods: OPTISOINS01 was a multicenter, prospective, observational study including early BC patients from diagnosis to one-year follow-up. Direct medical costs (in-hospital and out-ofhospital costs, supportive care costs) and direct non-medical costs (transportation and sick leave costs) were calculated by using a cost-of-illness analysis based on a bottom-up approach.Resources consumed were recorded in situ for each patient, using a prospective direct observation method. Results: Data from 604 patients were analyzed. Median direct medical costs of 1 year of management after diagnosis in operable BC patients were €12,250. Factors independently associated with higher direct medical costs were: diagnosis on the basis of clinical signs, invasive cancer, lymph node involvement and conventional hospitalization for surgery. Median sick leave costs were €8,841 per patient and per year. Chemotherapy was an independent determinant of sick leave costs (€3,687/patient/year without chemotherapy versus €10,706 with chemotherapy). Forty percent (n=242) of patients declared additional personal expenditure of €614/patient/year. No drivers of these costs were identified.Conclusion: Initial stage of disease and the treatments administered were the main drivers of direct medical costs. Direct non-medical costs essentially consisted of sick leave costs, accounting for one-half of direct medical costs for working patients. Out-of-pocket expenditure had a limited impact on the household.

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

Han

Yang

et al. 2016

J Cancer Res Clin Oncol

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Implementation of a clinical pathway in breast cancer patients undergoing breast surgery

Cited by 21 publications

References 15 publications

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

Direct medical and non-medical costs of a one-year care pathway for early breast cancer: results of a French multicenter prospective study

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

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