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. 2023 Dec;12(12):e230023.
doi: 10.57264/cer-2023-0023. Epub 2023 Nov 2.

Redesign of radiotherapy for prostate cancer: a proposal for universal healthcare systems

Ana Paula Beck da Silva Etges  1   2   3 , Luciana Rodrigues de Lara  1 , Stella Lisboa Sapper  4 , Ana Von Frankenberg Berger  4 , Melissa Streck  4 , Laise Zardo  5 , Armani Linhares  6   7 , Marina Nassif  8 , Angélica Zanotto  1 , Marta Nassif Pereira Lima  8 , Rafael Vargas  1   6   5 , Carisi Anne Polanczyk  1   3   8   9
Affiliations

Redesign of radiotherapy for prostate cancer: a proposal for universal healthcare systems

Ana Paula Beck da Silva Etges et al. J Comp Eff Res. 2023 Dec.

Abstract

Aim: This study was designed to recommend strategies to improve prostate patients' access to radiotherapy treatment in the Brazilian Unified Health System, along with a cost-tool to support radiotherapy care pathways' lead times and costs. Methods: Data was collected prospectively from patients with prostate cancer receiving radiotherapy in two Brazilian centers to provide data to apply design thinking and process reengineering techniques. The current status of the radiotherapy pathway was determined and the length of time taken for in-hospital activities was measured using data exported from ARIA®. Interviews with patients were used to estimate their waiting periods. This provided the data used to provide recommended strategies and the cost tool based on time-driven activity-based costing. The strategies were classified according to priority. Results: Data from 47 patients were analyzed. The mean interval from diagnosis to start of radiotherapy was 349 days (SD581), and the mean interval from seeking medical attention to starting treatment was 635 days (SD629). Twelve strategies affecting in-hospital processes and 11 impacting patients' care pathways and experiences are recommended, mostly focused on system improvement opportunities. A time-driven activity-based costing monitoring using data extracted from ARIA was coded and can be used by centers as a cost assessment guide. Conclusion: This study uses reengineering and design techniques to introduce priority strategies to allow more efficient and patient-centered radiotherapy.

Keywords: costs; design thinking; prostate cancer; radiotherapy; value-based healthcare.

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Conflict of interest statement

Competing interest disclosure

The authors have no financial and/or nonfinancial competing interests or relevant affiliations with any organization/entity to declare that are relevant to the subject matter or materials discussed in this manuscript. This includes employment, grants or research funding, consultancies, membership on scientific or other advisory boards, honoraria, stock ownership or options, paid expert testimony, patents received or pending, or royalties.

Figures

Figure 1.
Figure 1.. Methodology based on design thinking principles.
Figure 2.
Figure 2.. Mean interval between activities and the percentage of patients undergoing each activity.
Time is expressed in days. The percentages represent the proportion of patients that were submitted to each activity.
Figure 3.
Figure 3.. Categorization of the recommended strategies.
Figure 4.
Figure 4.. Recommendation priority matrix.
See this image and copyright information in PMC

References

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