360 健康分析（H360）-比较葡萄牙不同医疗机构乳腺癌管理的关键绩效指标。
360 Health Analysis (H360)-A Comparison of Key Performance Indicators in Breast Cancer Management across Health Institution Settings in Portugal.
机构信息
Institute of Health Sciences, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal.
Hospital de São João, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal.
出版信息
Curr Oncol. 2023 Jun 23;30(7):6041-6065. doi: 10.3390/curroncol30070451.
BACKGROUND
The increased focus on quality indicators (QIs) and the use of clinical registries in real-world cancer studies have increased compliance with therapeutic standards and patient survival. The European Society of Breast Cancer Specialists (EUSOMA) established QIs to assess compliance with current standards in breast cancer care.
METHODS
This retrospective study is part of H360 Health Analysis and aims to describe compliance with EUSOMA QIs in breast cancer management in different hospital settings (public vs. private; general hospitals vs. oncology centers). A set of key performance indicators (KPIs) was selected based on EUSOMA and previously identified QIs. Secondary data were retrieved from patients' clinical records. Compliance with target KPIs in different disease stages was compared with minimum and target EUSOMA standards.
RESULTS
A total of 259 patient records were assessed. In stages I, II, and III, 18 KPIs met target EUSOMA standards, 5 met minimum standards, and 8 failed to meet minimum standards. Compliance with KPIs varied according to the type of hospital (particularly regarding diagnosis) and disease stage. Although small differences were found in KPI compliance among institutions, several statistical differences were found among treatment KPIs according to disease stage, particularly in stage III.
CONCLUSIONS
This study represents the first assessment of the quality of breast cancer care in different hospital settings in Portugal and shows that, although most QIs meet EUSOMA standards, there is room for improvement. Differences have been found across institutions, particularly between oncology centers and general hospitals, in diagnosis and compliance with KPIs among disease stages. Stage III showed the greatest variability in compliance with treatment KPIs, probably related to the lower specificity of the guidelines in this disease stage.
背景
对质量指标（QIs）的关注度不断提高，以及在真实世界的癌症研究中使用临床登记，提高了治疗标准的遵从性和患者的生存率。欧洲乳腺肿瘤专家学会（EUSOMA）制定了 QIs，以评估在乳腺癌护理中对当前标准的遵从性。
方法
这项回顾性研究是 H360 健康分析的一部分，旨在描述不同医院环境（公立与私立、综合医院与肿瘤中心）中乳腺癌管理中 EUSOMA QIs 的遵从性。根据 EUSOMA 和先前确定的 QIs，选择了一组关键绩效指标（KPIs）。次要数据从患者的临床记录中检索。不同疾病阶段的 KPI 遵从性与 EUSOMA 的最低和目标标准进行了比较。
结果
共评估了 259 份患者记录。在 I、II 和 III 期，18 个 KPIs 达到了 EUSOMA 的目标标准，5 个达到了最低标准，8 个未达到最低标准。KPI 的遵从性因医院类型（特别是诊断方面）和疾病阶段而异。尽管各机构之间的 KPI 遵从性存在微小差异，但根据疾病阶段，特别是在 III 期，治疗 KPI 之间存在统计学差异。
结论
这项研究代表了对葡萄牙不同医院环境中乳腺癌护理质量的首次评估，表明尽管大多数 QIs 符合 EUSOMA 标准，但仍有改进的空间。各机构之间存在差异，特别是在肿瘤中心和综合医院之间，在诊断和疾病阶段的 KPI 遵从性方面。III 期在治疗 KPI 的遵从性方面表现出最大的变异性，这可能与该疾病阶段指南的特异性较低有关。
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