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在欧洲癌症中心(ECCs)实施质量指标。

Implementing quality metrics in European Cancer Centers (ECCs).

机构信息

German Cancer Society, Kuno-Fischer-Strasse 8, 14057, Berlin, Germany.

出版信息

World J Urol. 2021 Jan;39(1):49-56. doi: 10.1007/s00345-020-03165-4. Epub 2020 Apr 6.

Abstract

PURPOSE

Since 2014, prostate cancer centers outside Germany (PCCoG) are eligible for certification according to the criteria set out by the German Cancer Society (DKG). These centers must fulfill the same requirements as their German counterparts. The article reports on the experiences of the first nine certified PCCoG, with a focus on their indicator results.

METHOD

Following a descriptive analysis about primary case distribution, indicator definitions, and patient numbers, we compared indicator results for all 114 German PCC with all 9 PCCoG that have been certified for at least 3 years. Median centers' proportion was calculated and overall proportion for every indicator. Two-sided Cochran-Armitage tests were applied to detect trends over time.

RESULTS

The number of primary cases increased for both groups steadily from 2015 to 2017 as did fulfillment of most other indicators including PCa guideline-derived indicators. Requirements that proved to be hard to fulfill for PCCoG initially included psycho-oncological services (POS) and social service counselling (SCC). Fulfillment of POS requirements improved in the following years after initial certification in PCCoG. SCC rates remain low in PCCoG due to the different health system structures.

CONCLUSION

Acquiring a certificate by the DKG is achievable for PCCoG. Candidate centers need to be aware that substantial effort is required to fulfill the criteria, but once this is done, typically an improvement of indicators and an increase in patient numbers can be observed. Different health-care systems need to be taken into consideration and the certification requirements adapted in different areas to allow country-specific implementation.

摘要

目的

自 2014 年以来,德国以外的前列腺癌中心(PCCoG)有资格根据德国癌症协会(DKG)制定的标准进行认证。这些中心必须满足与德国同行相同的要求。本文报告了首批九个获得认证的 PCCoG 的经验,重点介绍了他们的指标结果。

方法

在对主要病例分布、指标定义和患者数量进行描述性分析后,我们比较了所有 114 个德国 PCC 的指标结果和所有至少已认证 3 年的 9 个 PCCoG 的指标结果。计算了中位数中心的比例和每个指标的总体比例。应用双侧 Cochran-Armitage 检验来检测随时间的趋势。

结果

两组的主要病例数量从 2015 年到 2017 年稳步增加,大多数其他指标(包括基于前列腺癌指南的指标)的完成情况也是如此。最初对 PCCoG 来说难以满足的要求包括心理肿瘤学服务(POS)和社会服务咨询(SCC)。在 PCCoG 获得初始认证后的几年中,POS 要求的履行情况有所改善。由于不同的卫生系统结构,SCC 率在 PCCoG 中仍然较低。

结论

PCCoG 可以获得 DKG 的认证。候选中心需要意识到,要满足标准需要付出大量努力,但一旦完成,通常可以观察到指标的改善和患者数量的增加。需要考虑不同的医疗保健系统,并在不同领域调整认证要求,以允许在特定国家实施。

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