Key performance indicators for monitoring the integrated care pathway in breast cancer: the E.Pic.A. project
Mattia Altini,
William Balzi,
Roberta Maltoni,
Fabio Falcini,
Flavia Foca,
Giovanni Messori Ioli,
Andrea Ricotti,
Oscar Bertetto,
Marinella Mistrangelo,
Gianni Amunni,
Fabrizio Gemmi,
Letizia Bachini,
Andrea Silenzi,
Roberta Pastorino,
Andrea Barbara,
Andrea Pierini,
Ilaria Massa
Affiliations
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
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
Flavia Foca
Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola - Italy
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
Marinella Mistrangelo
Dipartimento Interaziendale Interregionale Rete Oncologica Piemonte-Valle d’Aosta, Torino - Italy
Gianni Amunni
Regional Health Agency of Tuscany, Firenze -Italy
Fabrizio Gemmi
Regional Health Agency of Tuscany, Firenze -Italy
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
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
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)
