scholarly journals DRGs-based health system performance for breast cancer patients

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.

scholarly journals DRGs-based health system performance for breast cancer patients

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.

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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xinkui Liu ◽  
Furong Liu ◽  
Lin Wang ◽  
MengFan Wu ◽  
LinPeng Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Medical Service ◽  
Diagnosis Related Groups ◽  
Efficiency Index ◽  
Henan Province ◽  
Total Weight ◽  
Breast Cancer Patients ◽  
Average Annual Rate ◽  
Medical Safety

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.

scholarly journals Diabetes and Overall Survival among Breast Cancer Patients in the U.S. Military Health System

2017 ◽  
Vol 27 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Stephanie Shao ◽  
Abegail A. Gill ◽  
Shelia H. Zahm ◽  
Ismail Jatoi ◽  
Craig D. Shriver ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Health System ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Military Health System ◽  
Military Health ◽  
The U.S

Evaluating data-driven breast surgery treatment path visualizations from registry and administrative data.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 195-195
Author(s):  
Ravi V Atreya ◽  
Alexander S Taylor ◽  
Mia Alyce Levy
Keyword(s):  
Breast Cancer ◽  
Health System ◽  
Cancer Patients ◽  
Administrative Data ◽  
Cancer Registry ◽  
Educational Intervention ◽  
Surgical Care ◽  
Data Driven ◽  
Breast Cancer Patients ◽  
Learning Health System

195 Background: Breast cancer patients face difficult decisions about their surgical care without a full understanding of their options. The learning health system goal is to use information from the care of prior patients to inform the care of future patients. We aim to apply this concept to generate data-driven surgical paths, develop interactive path visualizations to inform patients, and evaluate their impact. Methods: We used cancer registry and administrative CPT codes for women diagnosed with stage 0-III breast cancer between FY2010-14 at a comprehensive cancer center. We generated surgical event sequences and visualized them using interactive Sankey diagram path visualizations. We will run a prospective educational intervention this winter to evaluate their impact on the shared decision making process. A web-based application will be available to patients prior to, during, and after their surgical clinic visit; we will survey their reaction pre-visit, post-visit, and post-surgery. Results: 1556 patients had 1951 surgical events in the registry and 48% started their surgical care with a breast conserving surgery while 52% began with a mastectomy. Mastectomy paths are presented in Table 1. We have developed interactive visualizations for patients to view, will be conducting our prospective educational intervention this winter, and will be ready to present preliminary results in February. Conclusions: We have been able to develop interactive, data-driven surgical path visualizations for breast cancer patients from cancer registry and administrative data. We will be conducting a prospective educational intervention to evaluate our implementation of this learning health system concept. [Table: see text]

Racial disparities in utilization of gene expression testing in breast cancer patients at an academic medical center.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 142-142
Author(s):  
Laura Alder ◽  
Harry Douglas Bear ◽  
Mary Helen Hackney
Keyword(s):  
Breast Cancer ◽  
Gene Expression ◽  
Health System ◽  
Gene Expression Profiling ◽  
Cancer Patients ◽  
Expression Profiling ◽  
Genomic Testing ◽  
Breast Cancer Patients ◽  
Nccn Guidelines ◽  
Chi Square Analysis

142 Background: Gene expression profiling of breast cancers, such as the OncotypeDx (ODX) test, PAM 50 and Mammaprint, can define the risk of distant recurrence and assist with decisions about adjuvant chemotherapy. A recent study of all breast cancer patients in Virginia found that only 11.7 % of Caucasian Americans (CA) and 5.1% of African Americans (AA) received genomic testing. Methods: We utilized the Virginia Commonwealth University Health System (VCUHS) Tumor Registry and billing data from 2010-2017 to identify all patients that met the following criteria per NCCN guidelines for genomic testing: early stage (stage I or II) breast cancer, estrogen and/or progesterone receptor positive and lymph node-negative breast cancer. We also obtained records from Genomic Health on ODX testing ordered through VCU Health. Additionally, ODX utilization was stratified by race. We then performed Chi Square analysis. Results: 1080 patients were eligible per NCCN Guidelines. Of these, 248 were eliminated due to having only radiation performed at VCU. 39 were eliminated because initial treatments were at outside hospitals. Of the remaining 793, 536 were CA, 232 AA, 9 Asian and 16 other. Among the patients for whom a genomic test was appropriate, the proportion who actually had such a test performed were: 83.4% for CA, 71.98% for AA, 55.56% for Asians, 81.25 % for Others and 79.7% overall. There was a significant difference between utilization in CAs and AAs (p < 0.001). Conclusions: Breast cancer patients at VCU Health are far more likely to receive gene expression profiling overall compared to the Commonwealth of VA as a whole. This may reflect more equitable and guideline-compliant care in an academic/safety net health system.

Factors contributing to persistent rates of contralateral prophylactic mastectomy in breast cancer patients: Examination of 1051 mastectomies across a single health system

2020 ◽  
Vol 26 (12) ◽  
pp. 2341-2349
Author(s):  
Jenna C. Bekeny ◽  
Caroline A. Schreeder ◽  
Peter Wirth ◽  
Kyle Luvisa ◽  
Idanis M. Perez‐Alvarez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health System ◽  
Cancer Patients ◽  
Prophylactic Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Breast Cancer Patients

scholarly journals Origin-destination flows in chemotherapy for breast cancer in Brazil: implications for pharmaceutical services

2019 ◽  
Vol 24 (3) ◽  
pp. 1153-1164 ◽  
Author(s):  
Mário Jorge Sobreira da Silva ◽  
Enirtes Caetano Prates Melo ◽  
Claudia Garcia Serpa Osorio-de-Castro
Keyword(s):  
Breast Cancer ◽  
Health System ◽  
Cancer Patients ◽  
Cancer Care ◽  
Ecological Study ◽  
Pharmaceutical Services ◽  
Breast Cancer Patients ◽  
Breast Cancer Chemotherapy ◽  
Unified Health System ◽  
Outpatient Chemotherapy

Abstract This study maps and analyzes patient flows for breast cancer chemotherapy in order to identify the potential implications for organization of pharmaceutical services in the cancer care network. An ecological study design sought to correlate the place of residence with place of care for breast cancer patients. All chemotherapy procedures financed by Brazil’s Unified Health System (SUS) and performed from January to December 2013 were included. Flows were mapped using TerraView® software. A total of 1 347 803 outpatient chemotherapy procedures were delivered by 243 cancer care units located in 156 municipalities. Seventeen cities concentrated approximately 50.0 % of the procedures. A total of 8 538 origin-destination flows were generated and 49.2% of procedures were performed in services located outside the municipality in which the patient resided. Context challenges, related to inequality of access to chemotherapy and hindrances in planning and management of pharmaceutical services, were discussed.

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