Relevance of Health Economics in Breast Cancer Treatment: Integration of Economics in the Management of Breast Cancer at the Clinic Level

Abstract

Since the introduction of the diagnosis-related groups (DRG) system with cost-related and entity-specific flat-rate reimbursements for all in-patients in 2004 in Germany, economics have become an important focus in medical care, including breast centers. Since then, physicians and hospitals have had to gradually take on more and more financial responsibilities for their medical care to avoid losses for their institutions. Due to financial limitations of resources, most medical services have to be adjusted to correlating revenues, which results in the development of a variety of active measures to understand, steer, and optimize costs, resources and related processes for breast cancer treatment. In this review, the challenging task to implement microeconomic management at the clinic level for breast cancer treatment is analyzed from breast cancer-specific publications. The newly developed economic management perspective is identified for different stakeholders in the healthcare system, and successful microeconomic projects and future aspects are described.

Day Surgery Management of Early Breast Cancer: Feasibility and Psychological Outcomes

“…In spite of this, in our country most patients undergoing breast conserving surgery and SLNB for treatment of early breast cancer are hospitalized for at least one or two nights. Considering that in most countries reimbursements are calculated on a fee-forservice basis, according to the diagnosis-related-group (DRG) system guidelines, it is clear that treatment for early breast cancer in a Day Surgery setting (DS) could represent a significant saving as it relates to cost of care (2).…”

Considerations on the Surgical Treatment of Duct Carcinoma in Situ (Dcis) of the Breast From DRG System Perspective

“…In a recent study published in The Breast regarding hospital reimbursement in 11 European countries the reimbursement for a vignette case of partial mastectomy varied from 577 Euros in Poland to 5780 Euros in Netherlands [3]. It is a wide range, expressing economic and health politics differences, but also expressing different efforts to adjust breast care activity to limitations of financial resources and to implement microeconomic management at the clinic level of breast care [4]. …”

Health economics of breast cancer management: An oversight

“…Moreover, the implementation of properly qualified breast cancer centers, comprehensive multidisciplinary teams and the institution of quality assurance measures to help foster a standard of care for breast cancer management require considerable costs [2] . The proper assessment of aspects relevant to breast cancer health economics should be conducted after joint discussion between breast cancer physicians and experts in health economics and quality of medical care [3] . A frequently overlooked issue in measuring the advances in breast cancer management has been the impact of these advances on healthcare resource utilization.…”