在4个早期采用中心引入包括超短住院时间的乳腺癌护理计划：一项实施研究的框架

Introduction of a breast cancer care programme including ultra short hospital stay in 4 early adopter centres: framework for an implementation study.

作者信息

de Kok Mascha, Frotscher Caroline N A, van der Weijden Trudy, Kessels Alfons G H, Dirksen Carmen D, van de Velde Cornelis J H, Roukema Jan A, Bell Antoine V R J, van der Ent Fred W, von Meyenfeldt Maarten F

机构信息

Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands.

出版信息

BMC Cancer. 2007 Jul 2;7:117. doi: 10.1186/1471-2407-7-117.

DOI:10.1186/1471-2407-7-117

PMID:17605796

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1914078/

Abstract

BACKGROUND

Whereas ultra-short stay (day care or 24 hour hospitalisation) following breast cancer surgery was introduced in the US and Canada in the 1990s, it is not yet common practice in Europe. This paper describes the design of the MaDO study, which involves the implementation of ultra short stay admission for patients after breast cancer surgery, and evaluates whether the targets of the implementation strategy are reached. The ultra short stay programme and the applied implementation strategy will be evaluated from the economic perspective.

METHODS/DESIGN: The MaDO study is a pre-post-controlled multi-centre study, that is performed in four hospitals in the Netherlands. It includes a pre and post measuring period of six months each with six months of implementation in between in at least 40 patients per hospital per measurement period. Primary outcome measure is the percentage of patients treated in ultra short stay. Secondary endpoints are the percentage of patients treated according to protocol, degree of involvement of home care nursing, quality of care from the patient's perspective, cost-effectiveness of the ultra short stay programme and cost-effectiveness of the implementation strategy. Quality of care will be measured by the QUOTE-breast cancer instrument, cost-effectiveness of the ultra short stay programme will be measured by means of the EuroQol (administered at four time-points) and a cost book for patients. Cost-effectiveness analysis will be performed from a societal perspective. Cost-effectiveness of the implementation strategy will be measured by determination of the costs of implementation activities.

DISCUSSION

This study will reveal barriers and facilitators for implementation of the ultra short stay programme. Moreover, the results of the study will provide information about the cost-effectiveness of the ultra short stay programme and the implementation strategy.

TRIAL REGISTRATION

Current Controlled Trials ISRCTN77253391.

摘要

背景

20世纪90年代，美国和加拿大引入了乳腺癌手术后的超短住院（日间护理或24小时住院），但在欧洲仍未成为普遍做法。本文描述了MaDO研究的设计，该研究涉及对乳腺癌手术后患者实施超短住院，并评估实施策略的目标是否达成。将从经济角度评估超短住院计划和应用的实施策略。

方法/设计：MaDO研究是一项前后对照的多中心研究，在荷兰的四家医院进行。它包括前后各六个月的测量期，中间有六个月的实施期，每个测量期每家医院至少有40名患者。主要结局指标是接受超短住院治疗的患者百分比。次要终点包括按照方案治疗的患者百分比、家庭护理参与程度、患者视角的护理质量、超短住院计划的成本效益以及实施策略的成本效益。护理质量将通过乳腺癌专用的QUOTE工具进行测量，超短住院计划的成本效益将通过欧洲五维度健康量表（在四个时间点进行评估）和患者成本账簿进行测量。成本效益分析将从社会角度进行。实施策略的成本效益将通过确定实施活动的成本来衡量。