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CC BY-NC-ND 4.0 · Senologie - Zeitschrift für Mammadiagnostik und -therapie 2023; 20(02): 141-150
DOI: 10.1055/a-2045-0609
Scientific Discussion

Can We Still Afford Innovative Surgical Procedures?

A structure and process analysis of the cost coverage of surgical therapy for patients with breast cancer in Germany with health economic evaluation examples based on superparamagnetic marking Artikel in mehreren Sprachen: English | deutsch
Michael Patrick Lux
1   Frauenklinik St. Louise, St. Vincenz-Krankenhaus GmbH, Klinik für Gynäkologie und Geburtshilfe, Paderborn, Deutschland
2   St. Josefs-Krankenhaus, St. Vincenz-Krankenhaus GmbH, Klinik für Gynäkologie und Geburtshilfe, Salzkotten, Deutschland
,
Michael Untch
3   Interdisziplinäres Brustzentrum, Helios Klinikum Berlin Buch, Klinik für Gynäkologie und Geburtshilfe, Berlin, Deutschland
,
Hans-Christian Kolberg
4   Klinik für Gynäkologie und Geburtshilfe, Marienhospital Bottrop gGmbH, Bottrop, Deutschland (Ringgold ID: RIN536271)
,
Michael Friedrich
5   Klinik für Frauenheilkunde und Geburtshilfe, HELIOS Klinikum Krefeld, Krefeld, Deutschland (Ringgold ID: RIN27664)
,
Marc Thill
6   Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus, Frankfurt am Main, Deutschland (Ringgold ID: RIN84491)
,
Florian Schütz
7   Klinik für Gynäkologie und Geburtshilfe, Diakonissen-Stiftungs-Krankenhaus Speyer, Speyer, Deutschland (Ringgold ID: RIN123168)
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Abstract

Introduction Hospitals are currently facing major financial challenges. Due to the high incidence of breast cancer and the complex range of associated services, surgical treatment of breast cancer is a particular case in point when it comes to the question of cost coverage for innovative versus established procedures by the service providers. The aim of this study is to shed light from a healthcare economics perspective on the current situation of hospitals in Germany with regard to their different structures and processes for breast-conserving therapy.

Materials and methods An online questionnaire with 46 questions was developed and made available to hospitals that are members of the AGO [German Working Group for Gynecological Oncology] Breast Committee and AWOgyn [German Working Group for Cosmetic, Plastic and Reconstructive Surgery in Gynecology], as well as AG-certified breast centers. The questions cover various parameters for health economics analysis, including primary case numbers, structures, and questions about tumor and sentinel marking and surgical procedures.

Results 142 hospitals or breast centers took part in the survey. 93% of the hospitals were certified. The average number of primary cases was 264.6 per year. In over 60% of the hospitals, the surgical procedure and surgery planning were influenced by capacity limitations of cooperation partners. “Targeted axillary dissection” was performed in 83.5% of the hospitals, and radioactive markers were most commonly used for sentinel lymph node marking. Over 60% of participating hospitals were highly satisfied with the marking method used.

Conclusion This structure and process analysis now makes it possible to reflect on the costs involved for hospitals of different sizes, in different regions, and with different funding models, and to use this as a basis for the economic evaluation of new surgical procedures within an overall context. In general, it is possible to make savings through innovative procedures in the surgical treatment of breast cancer.

Keywords

Breast cancer - Health economics - Surgical therapy - cost recovery - sentinel node biopsy


Publikationsverlauf

Artikel online veröffentlicht:
16. Juni 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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