Economic Constraints - the Growing Challenge for Western Breast Cancer Centers

Abstract

Breast cancer care in Western countries has reached a considerable level of quality and standardization, which has contributed to the decline in breast cancer mortality. Certified Breast Cancer Centers (BCC) represent an important element of this development. Related to changes in reimbursement and growing costs, BCC face economic constraints which ultimately could endanger the achievements of the past. Thus, BCC have to optimize their care strategies from an economic perspective, particularly by increasing efficiency but also by adapting their service portfolio. This could result in competitive advantages and additional revenue by increasing case numbers and extra charges to patients. Furthermore, an intensification of collaboration with the outpatient sector resulting in an integrated and managed ‘trans-sectoral' care approach which could allow to shift unprofitable procedures to the outpatient sector - in the sense of a win-win situation for both sectors and without loss of care quality - seems reasonable. Structured and specialized consulting approaches can further be a lever to fulfill economic requirements in order to avoid cuts in medical care quality for the sake of a balanced budget. In this review, economic constraints of BCC with a focus on the German healthcare system and potential approaches to ameliorate these financial burdens are being discussed.

‘Act on Oncology’ as a New Comprehensive Approach to Assess Prostate Cancer Centres – Method Description and Results of a Pilot Study

“…Despite the promising achievements in the implementation of multidisciplinarity at the staff level, the pilot study revealed the need for an overriding management framework to promote the collaboration among departments, to allow a corporate identity to evolve, and to canvas additional support. In this regard, it is important to note that an advanced organisational infrastructure appears to improve both outcomes of cancer patients [16] , [38] and cost efficiency of clinical processes [17] , [18] , [19] , [39] . As a first improvement that has been implemented in the meanwhile, the centre administration and the Health Director at INT described and formalised the organisation of the prostate cancer unit.…”

Health Economics in Breast Cancer

“…The emphasis of this issue is on the various points of view involved. In addition to basic healthcare economics [1], the viewpoint of the certified breast centers is considered [2], as well as those of the outpatient networks [3], diagnostic facilities in the context of mammography screening [4], and business management [5] (which still appears to be foreign to some medical specialists). In particular, the point of view of the patients, whose care must not be allowed to become the plaything of debates over costs, is presented [2].…”