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. 2014 Mar;74(3):276-283.
doi: 10.1055/s-0034-1368169.

Disease Management Project Breast Cancer in Hesse - 5-Year Survival Data: Successful Model of Intersectoral Communication for Quality Assurance

C Jackisch  1 , A Funk  2 , K König  3 , D Lubbe  4 , B Misselwitz  5 , U Wagner  6
Affiliations

Disease Management Project Breast Cancer in Hesse - 5-Year Survival Data: Successful Model of Intersectoral Communication for Quality Assurance

C Jackisch et al. Geburtshilfe Frauenheilkd. 2014 Mar.

Abstract
in English, German

Introduction: The Disease Management Project Breast Cancer (DMP Breast Cancer) was first launched in Hesse in 2004. The project is supported by the health insurance companies in Hesse and the Professional Association of Gynaecologists in Hesse. The aim is to offer structured treatment programmes to all women diagnosed with breast cancer in Hesse by creating intersectoral cooperations between coordinating clinics, associated hospitals and gynaecologists in private practice who registered in the DMP programme. Method: Between 1 January 2005 and 30 June 2011, 13 973 women were enrolled in the DMP programme. Results: After data cleansing, survival rates were calculated for a total of 11 214 women. The 5-year overall survival (OS) rate was 86.3 %; survival rates according to tumour stage on presentation were 92.2 % (pT1) and 82.3 % (pT2), respectively. The impact of steroid hormone receptor status on survival (87.8 % for receptor-positive cancers vs. 78.9 % for receptor-negative cancers) and of age at first diagnosis on survival (≤ 35 years = 91 %) were calculated. Conclusion: The project showed that intersectoral cooperation led to significant improvements in the quality of treatment over time, as measured by quality indicators and outcomes after treatment.

Einleitung: Das Disease-Management-Projekt Mammakarzinom (DMP-Mammakarzinom) wurde 2004 in Hessen als gemeinsame Maßnahme zwischen den Krankenkassen in Hessen und dem Berufsverband der Frauenärzte e. V. zur Durchführung eines strukturierten Behandlungsprogramms für Brustkrebspatientinnen eingeführt. Hierbei erfolgt eine sektorenüberschreitende Zusammenarbeit zwischen den Koordinationskrankenhäusern, den Kooperationskliniken und den Frauenärzten, die sich in das DMP-Programm eingeschrieben haben. Methodik: Die Analyse umfasst 13 973 Datensätze der in das DMP-Programm eingeschriebenen Patientinnen vom 01. 01. 2005 bis zum 30. 06. 2011. Ergebnisse: Nach Datenbereinigung konnten für 11 214 Frauen Daten zum 5-Jahres-Überleben (86,3 %) sowie zum Überleben nach Tumorgröße (pT1 = 92,2 %, pT2 = 82,3 %) errechnet werden. Ebenso wurde die Bedeutung des Steroidhormon-Rezeptorstatus (87,8 % für rezeptorpositive Karzinome vs. 78,9 % für rezeptornegative Karzinome) auf das Überleben und das Alter bei Erstdiagnose (≤ 35 Jahre = 91 %) betrachtet. Zusammenfassung: Das Projekt zeigt, dass die intersektorale Einrichtung und die Kooperation im Beobachtungszeitraum zu einer deutlichen Verbesserung der Behandlungsqualität, gemessen an den Qualitätsindikatoren, aber auch am Behandlungsergebnis beigetragen haben.

Keywords: breast cancer; disease management programme; network; quality assurance; survival.

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Conflict of interest statement

Conflict of Interest None.

Figures

Fig. 1
Fig. 1
Overview of breast centres of excellence in Hesse – DMP Breast Cancer Hesse – Breast Cancer Centres of Excellence (1 coordinating + cooperating hospital per centre).
Fig. 2
Fig. 2
Network of coordinating hospitals/cooperating hospitals.
Fig. 3
Fig. 3
Overview of GQH quality indicators for breast cancer 2004–2006.
Fig. 4
Fig. 4
Overview of GQH quality indicators for breast cancer 2010.
Fig. 5
Fig. 5
Overview of basic data collected. n.s.: not specified.
Fig. 6
Fig. 6
Overall survival for all DMP patients whose data were available for analysis.
Fig. 7
Fig. 7
Overall survival according to tumour stage.
Fig. 8
Fig. 8
Survival rate according to hormone receptor status.
Fig. 9
Fig. 9
Survival rate according to age at first diagnosis.
See this image and copyright information in PMC

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