OBJECTIVES: At Luz Saúde we implemented an automatic process for collecting Patient Reported Outcome Measures (PROM) and extracting clinical results and costs, which in the end are compiled and treated to improve clinical practice through visualization using dashboards. This study aims to evaluate our process of Value-Based Healthcare (VBH) and results obtained using this methodology in the context of breast cancer.

METHODS: Patients were included between 2019 and 2022, using ICD codes for malignant breast cancer pathology, who had completed at least one therapeutic intervention in our hospitals (Pharmacological, Surgical or Radiotherapy). Clinical results were collected directly from the electronic medical record and included case-mix variables. The PROM used were QLQ C30, BR-23 and Breast-Q, and were collected through the Luz Saúde digital platform. All data were aggregated in a dedicated data lake, statistically analyzed using Python, including multivariate risk adjustment, and visualized in Microsoft PowerBI.

RESULTS: The study included 1078 patients, with an average age of 57 years and of these, 635 (59%) had stage I or II disease at the time of diagnosis. About 8% (86) of patients had in situ disease. The average Ki-67 was 29.5 and only 12% were HER-2 Positive. After surgery, only 9.5% of patients had Surgical Radicality R1 and 1% had surgical complications. Quality of life at baseline was 67% and improved to 85% after 1 year of treatment. Reported neuropathy increased by 2% during treatment. The adjusted overall survival for stage IV patients was 35 months. The cost of treatment was higher the first year and then decreased by half and remained constant.

CONCLUSIONS: This study demonstrates that it is possible to implement a complete VBHC model, focusing on the results that really matter to patients and the costs associated with achieving them, thus contributing to a more sustainable ecosystem between all stakeholders involved.