Schärer Markus, Heesen Philip, Bode-Lesniewska Beata, Studer Gabriela, Fuchs Bruno
Sarcoma Service, Department of Orthopaedics and Trauma, University Teaching Hospital LUKS, 6000 Lucerne, Switzerland.
Health Sciences and Medical Faculty, University of Lucerne, 6001 Lucerne, Switzerland.
Cancers (Basel). 2023 Dec 15;15(24):5849. doi: 10.3390/cancers15245849.
Benchmarking is a fundamental tool for enhancing quality within a patient-centered healthcare framework. This study presents an analysis of time-to-treatment initiation (TTI) for sarcoma patients, utilizing a database encompassing 266 cases from the Swiss Sarcoma Network. Our findings indicate a median TTI of 30 days across the cohort, with bone sarcomas and deep soft tissue sarcomas demonstrating a shorter median TTI of 28 days, followed by superficial soft tissue sarcomas at 42 days. The data reveal that the use of real-world-time data (RWTD) may account for a longer TTI observed, as it offers more comprehensive capture of patient journeys, unlike conventional datasets. Notably, variability in TTI was observed between different treatment institutions, which underscores the need for standardized processes across centers. We advocate for a selective referral system to specialized centers to prevent capacity overload and ensure timely treatment initiation. Our analysis also identified significant delays in TTI for unplanned 'whoops'-resections, highlighting the importance of early specialist referral in optimizing treatment timelines. This study emphasizes the potential benefits of a streamlined, data-informed approach to sarcoma care. However, further research is required to establish the direct impact of integrated care models on TTI and patient outcomes in the context of sarcoma treatment.
基准测试是在以患者为中心的医疗保健框架内提高质量的一项基本工具。本研究对肉瘤患者的治疗开始时间(TTI)进行了分析,利用了一个包含瑞士肉瘤网络266例病例的数据库。我们的研究结果表明,整个队列的TTI中位数为30天,骨肉瘤和深部软组织肉瘤的TTI中位数较短,为28天,其次是浅表软组织肉瘤,为42天。数据显示,使用真实世界数据(RWTD)可能是观察到TTI较长的原因,因为与传统数据集不同,它能更全面地记录患者病程。值得注意的是,不同治疗机构之间观察到TTI存在差异,这凸显了各中心标准化流程的必要性。我们主张建立一个向专科中心的选择性转诊系统,以防止能力过载并确保及时开始治疗。我们的分析还发现,计划外的“哎呀”切除手术的TTI存在显著延迟,这突出了早期专科转诊对优化治疗时间线的重要性。本研究强调了采用简化的、基于数据的方法治疗肉瘤的潜在益处。然而,需要进一步研究以确定综合护理模式在肉瘤治疗背景下对TTI和患者结局的直接影响。