Performance evaluation of medical service for breast cancer patients based on diagnosis related groups

Abstract Background To evaluate the performance of medical service for patients with breast cancer in Henan Province, China, using diagnosis related groups (DRGs) indicators and to 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 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) was 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 low-risk group cases (IMLRG) were used to evaluate medical service efficiency and medical safety. Results Between 2016 and 2019, there were 103,760 patients with breast cancer. The total weight increased over the study period at an average annual rate of 21.71%. 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 performance of medical service improved between 2016 and 2019 for breast cancer patients discharged from study hospitals in Henan Province. The main area of improvement was 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 is an effective evaluation tool.

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DRGs-based health system performance for breast cancer patients

10.21203/rs.3.rs-20222/v2 ◽

2020 ◽

Author(s):

Xinkui Liu ◽

Furong Liu ◽

Lin Wang ◽

MengFan Wu ◽

LinPeng Yang ◽

...

Keyword(s):

Breast Cancer ◽

Health System ◽

Cancer Patients ◽

System Performance ◽

Efficiency Index ◽

Henan Province ◽

Health System Performance ◽

Breast Cancer Patients ◽

Average Annual Rate ◽

Medical Safety

Abstract 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 low-risk 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.

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DRGs-based health system performance for breast cancer patients

10.21203/rs.3.rs-20222/v1 ◽

2020 ◽

Author(s):

Xinkui Liu ◽

Furong Liu ◽

Lin Wang ◽

MengFan Wu ◽

LinPeng Yang ◽

...

Keyword(s):

Breast Cancer ◽

Health System ◽

Cancer Patients ◽

System Performance ◽

Efficiency Index ◽

Henan Province ◽

Health System Performance ◽

Breast Cancer Patients ◽

Average Annual Rate ◽

Medical Safety

Abstract 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 low-risk 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.

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Molecular typing of breast cancer in Northern Henan Province

10.1101/2021.07.28.21261239 ◽

2021 ◽

Author(s):

Hui Zhao ◽

Haibin Ma ◽

Bangze Chen ◽

Yahui Li ◽

Junzheng yang

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Molecular Typing ◽

Ductal Carcinoma ◽

Henan Province ◽

Type I ◽

Breast Cancer Patients ◽

Ki 67 ◽

Luminal B ◽

Expression Rate

Objective: Investigating and analyzing the clinical features of breast cancer patients in Northern Henan Province, measuring expression of biomarkers (ER, PR, HER2 and Ki-67) and classified the molecular typing of breast cancer patients, to understand the molecular typing distribution and correlation between biomarkers of breast cancer patients in North Henan Province, which may provide the information for the local oncologist to make sound treatment plans. Methods: We collected the clinical data of breast cancer patients in Xinxiang Central Hospital from 2016 to 2021, those data was classified by gender and pathological types of breast cancer patients; and we also measured and analyzed the expression of breast cancer related biomarkers (ER, PR, HER2 and Ki-67) by immunohistochemistry, and based on expression of these biomarkers, the molecular typing of breast cancer were also classified. Results: 3210 cases breast cancer patients were collected in this study; there were 3205 female patients and 5 male patients, accounting for 99.84% and 0.16% in total breast cancer patients, respectively. Classification according to pathological conditions of breast cancer patients, there were 2761 cases patients with invasive ductal carcinoma, accounting for 86.01% in total breast cancer patients, and then mucinous adenocarcinoma (109/3210, 3.40%), lobular carcinoma (106/3210, 3.30%), ductal carcinoma in situ (75/3210, 2.34%), papillary carcinoma (61/3210, 1.90%), intraductal carcinoma (40/3210, 1.25%), myeloid carcinoma (27/3210, 0.84%); There were also including some rare breast cancer types including cribriform carcinoma (6/3210, 0.19%), lymph node metastasis (7/3210, 0.22%), occult breast carcinoma (5/3210, 0.14%), invasive carcinoma (5/3210, 0.14%), squamous cell carcinoma (3/3210, 0.09%), fibroadenoma (3/3210, 0.09%), pleomorphic carcinoma (2/3210, 0.06%). Classification according to molecular typing of breast cancer, the number of breast cancer patients with Luminal A type [ER(+)/PR(+) HER2(-)Ki67<14%] were 207 cases, accounting for 6.45% in total breast cancer patients, the number of breast cancer patients with Luminal B type I [ER(+)/PR(+) HER2(-)] were 243 cases, accounting for 7.57% in total breast cancer patients, the number of breast cancer patients with Luminal B type II [(ER(+)/PR(+)HER2(+) any Ki67] was 254 cases, accounting for 7.91% in total breast cancer patients, and the number of Triple-negative breast cancer (TNBC) were 390 cases, accounting for 12.15% in total breast cancer patients. The average expression rate of Ki-67 in ER (+) and/or PR (+) breast cancer patients was 20.39+27.33%, while the average expression rate of Ki-67 in ER(-)/PR(-) breast cancer patients was 36.35%+30.14%, and the difference between two patients was significant (p=0.0021); the average expression rate of Ki-67 in HER2 positive breast cancer patients was 23.01%+21.96%, the average expression rate of Ki-67 in HER2 negative breast cancer patients was 29.44%+24.16%, and there was no significant difference between the two groups (P=0.2589). The main treatment methods of breast cancer patients in Northern Henan Province were antitumor drugs and chemotherapy, the results showed that 87.29% patients were treated by chemotherapy; and high frequency anti-tumor drugs used for breast cancer treatment were Epirubicin (1527/3210, 47.57%)，Cyclophosphamide (1172/3210, 36.51%)，Paclitaxel (1141/3210，35.55%), Tamoxifen (912/3210, 28.41%). Conclusions: The main pathological type of breast cancer are invasive ductal carcinoma, and the main treatment methods of breast cancer patients in Northern Henan Province were antitumor drugs and chemotherapy. In the four kinds of molecular typing of breast cancer, the incidence rate of TNBC is highest compared with Luminal B type II[(ER(+)/PR(+)HER2(+) any Ki67], Luminal B type I [ER(+)/PR(+)HER2(-)] and Luminal A type [ER(+)/PR(+) HER2(-) Ki67<14%]; these results may provide some suggestions for the local oncologist.

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