East Midlands Breast Pain Pathway: An Evaluation of Community Breast Pain Clinics Across the East Midlands Cancer Alliance

IF 2.1 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
John F. R. Robertson, Thilan Bartholomeuz, Veronica Rogers, Kevin Clifton, Lucy Pirkle, Denise Stafford, Mike Ryan, D. Mark Sibbering
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引用次数: 0

Abstract

Rationale

Research indicates that breast pain as the sole symptom has no association with breast cancer. However, patients with breast pain only are often referred onto urgent breast cancer diagnostic pathways, leading to unnecessary anxiety and overutilisation of secondary health care services. The novel community breast pain clinic (CBPC) service in the UK aims to improve patient care while providing system-wide improvements for patients with breast pain, patients who have ‘red flag’ symptoms, as well as being cost-effective.

Aim and Objectives

This study seeks to evaluate and assess the impact of the CBPC on patient care, experience, and healthcare system improvements.

Methods

Quantitative and qualitative analysis of CBPC was undertaken using data from CBPC based on a core data set designed by the programme team, secondary care follow-up data, Patient Reported Outcomes Measure (PROMs) data and family history data.

Results

The CBPC was well-received by patients with 98.5% recommending the service. Additionally, health economic analysis indicated a cost benefit ratio of 1.23 in year 1, indicating a positive return on investment. Breast cancer incidence within the cohort was estimated at 3.2 per 1000, in line with population estimates in the literature. For those with a breast cancer diagnosis, there is no evidence of care delays or missed diagnoses via the service.

Conclusion

The CBPC offers significant benefits in patient experience and value for money, with no evidence of reducing patient safety. The impacts of the clinics appear to be reproducible across all five centres in the East Midlands (a population of 5.5 million). Recommendations on further assessment on optimal staff mix and clinic cost mechanisms should be considered to maximise benefits.

Abstract Image

东米德兰兹乳房疼痛途径:整个东米德兰兹癌症联盟社区乳房疼痛诊所的评估
研究表明,乳房疼痛作为唯一的症状与乳腺癌无关。然而,只有乳房疼痛的患者往往被转诊到紧急乳腺癌诊断途径,导致不必要的焦虑和过度使用二级保健服务。英国新型的社区乳房疼痛诊所(CBPC)服务旨在改善患者护理,同时为患有乳房疼痛的患者提供全系统改善,这些患者有“危险信号”症状,并且具有成本效益。目的和目的本研究旨在评估和评估CBPC对患者护理、经验和医疗保健系统改进的影响。方法采用基于项目团队设计的核心数据集的CBPC数据、二级护理随访数据、患者报告结局测量(PROMs)数据和家族史数据,对CBPC进行定量和定性分析。结果98.5%的患者推荐了CBPC服务,获得了良好的评价。此外,卫生经济分析表明,第一年的成本效益比为1.23,表明投资回报为正。该队列中的乳腺癌发病率估计为每1000人中3.2人,与文献中的人口估计相符。对于那些被诊断为乳腺癌的人来说,没有证据表明通过该服务会导致护理延误或漏诊。结论CBPC在患者体验和物有所值方面提供了显著的好处,没有证据表明会降低患者的安全性。这些诊所的影响似乎在东米德兰兹郡(人口550万)的所有五个中心都可以重现。应考虑进一步评估最佳工作人员组合和诊所费用机制的建议,以实现效益最大化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.80
自引率
4.20%
发文量
143
审稿时长
3-8 weeks
期刊介绍: The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.
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