Key performance indicators for monitoring the integrated care pathway in breast cancer: the E.Pic.A. project

  • Mattia Altini Healthcare Administration, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola - Italy
  • William Balzi Healthcare Administration, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola - Italy
  • Roberta Maltoni Breast Unit, Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola - Italy https://orcid.org/0000-0003-0366-792X
  • Fabio Falcini Romagna Tumor Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola and Azienda USL della Romagna, Forlì - Italy https://orcid.org/0000-0002-0864-6266
  • Flavia Foca Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola - Italy https://orcid.org/0000-0002-5529-4769
  • Giovanni Messori Ioli ASL CN2, Cuneo - Italy
  • Andrea Ricotti ASL CN2, Cuneo - Italy
  • Oscar Bertetto Dipartimento Interaziendale Interregionale Rete Oncologica Piemonte-Valle d’Aosta, Torino - Italy http://orcid.org/0000-0001-5133-2724
  • Marinella Mistrangelo Dipartimento Interaziendale Interregionale Rete Oncologica Piemonte-Valle d’Aosta, Torino - Italy https://orcid.org/0000-0001-7095-4748
  • Gianni Amunni Regional Health Agency of Tuscany, Firenze -Italy
  • Fabrizio Gemmi Regional Health Agency of Tuscany, Firenze -Italy https://orcid.org/0000-0002-1266-8433
  • Letizia Bachini Regional Health Agency of Tuscany, Firenze -Italy
  • Andrea Silenzi Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome - Italy https://orcid.org/0000-0002-0652-0520
  • Roberta Pastorino Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome - Italy
  • Andrea Barbara Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome - Italy https://orcid.org/0000-0001-5321-4537
  • Andrea Pierini Market Access, Roche S.p.A., Monza - Italy
  • Ilaria Massa Market Access, Roche S.p.A., Monza - Italy https://orcid.org/0000-0003-1388-3175
Keywords: Appropriateness, Breast cancer, Italian National Health System, Key performance indicators, Sustainability

Abstract

Background: Due to its high incidence, evaluating performance of care delivered to breast cancer patients is a crucial issue. The multidisciplinary panel E.Pic.A. (Economic Appropriateness of an Integrated Care Pathway) defined a set of key performance indicators (KPIs) to evaluate economic waste in breast cancer healthcare interventions.
Methods: The E.Pic.A. panel identified the principal KPIs that are crucial within the breast cancer care pathway to evaluate the performance of care. KPIs were defined taking into account their reliability, validity, usability and feasibility of measurement through the linkage between multiple routine healthcare data sources.
Results: Seven KPIs were identified: three on instrumental diagnostics, two on surgery and two on treatment. The three KPIs regarding instrumental diagnostics are aimed at assessing the inappropriateness of diagnostic tests performed before and after the index surgery. The two KPIs regarding surgery measure the inappropriateness of possible repeated interventions considering the time elapsed from the index surgery. The two KPIs regarding oncologic therapy measure the inappropriateness about the administration time of adjuvant therapy and radiotherapy considering the time elapsed from the index surgery.
Conclusion: E.Pic.A methodology could help to evaluate economic waste in healthcare interventions with the objective of redirecting resources to interventions with greater value. (HTA & Market Access)

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Published
2019-06-05
How to Cite
1.
Altini M, Balzi W, Maltoni R, Falcini F, Foca F, Messori IoliG, Ricotti A, Bertetto O, Mistrangelo M, Amunni G, Gemmi F, Bachini L, Silenzi A, Pastorino R, Barbara A, Pierini A, Massa I. Key performance indicators for monitoring the integrated care pathway in breast cancer: the E.Pic.A. project. Abtpn [Internet]. 5Jun.2019 [cited 6Jul.2020];6(1):31-8. Available from: https://journals.aboutscience.eu/index.php/aboutopen/article/view/291
Section
Original research article

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