EFFECTIVENESS OF IDENTIFYING A CANCER PATIENT IN THE HOSPITAL SECTOR IN NORTHERN-NORWAY - ANALYSES BASED ON REGIONAL PERFORMANCE DATABASE
Author(s)
Totth A1, Skjemstad ES1, Hjemås PC1, Storjord T2, Norum J3, Sundset R1
1Northern Norway Regional Health Authority Trust, Bodø, Norway, 2University Hospital of North Norway, Tromsø, Norway, 3UiT-The Arctic University of Norway, Tromsø, Norway
OBJECTIVES: Implementing a Danish model, Norway introduced 28 different, mostly organ-specified, standardized diagnostic pathways in 2015 for patients suspected to have a malignancy. In this paper, authors evaluate the main indicators and present the effectiveness of identifying a cancer patient using standardized diagnostic pathways in a secondary health care environment. METHODS: The Northern-Norway Regional Health Authority Trust established a database collecting all relevant information from medical records in all hospitals of the region according to cancer pathways (diagnostic procedures, involved institutions, time stamps, medical decisions) on a daily basis. All data recorded in the database has been anonymized. Data for patients who entered the secondary health care in 2015 were selected and analyzed. SAS software tools (Enterprise Guide 4.3, Visual Analytics 4.1) and MS Excel 2013 were used for data processing and analyses. RESULTS: A total number of 4 099 (100%) diagnostic cancer pathway cases were initiated in 2015. 56,08% of all identified cancer cases in 2015 (3 172) were diagnosed by pathway activities. 2 636 (67,3%) of all fulfilled pathways (3 917, 95,6%) were completed within national standard time intervals. Drop-out rate was 3%, in 52% cases the suspect of cancer was not confirmed, and 45% were identified as proven cancer patients. Effectiveness of pathways were estimated by the ratio of confirmed/unconfirmed cases in all pathways. This ratios shows a wide range of variation from 9% (sarcomas, N=11) til 100% (CLL n=4, gall bladder tumors n=7). Ratio among cancer types over 50 cases/year varies between 18% (esophagus and ventricular tumors N=197) til 87% (ovarian tumors N=60) CONCLUSIONS: Introduction of special and prioritized cancer diagnostic pathways provide a good tool for monitoring diagnostic processes. Wide range of variations have been found in effectivity. The described methods supports decision and policy makers to identify bottlenecks, analyze and monitor variations in order to increase effectiveness, subsequently avoiding unnecessary activities, risks and costs.
Conference/Value in Health Info
2016-10, ISPOR Europe 2016, Vienna, Austria
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PHS92
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Coverage with Evidence Development & Adaptive Pathways, Hospital and Clinical Practices
Disease
Oncology