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Iuri Amorim Santana



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    P12 - Health Services Research/Health Economics - Health Policy (ID 124)

    • Event: WCLC 2020
    • Type: Posters
    • Track: Health Services Research/Health Economics
    • Presentations: 1
    • Moderators:
    • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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      P12.02 - Implementation of a Timeliness-of-care Pathway System for Lung Cancer Patients in a Private Outpatient Oncology Service. (ID 3431)

      00:00 - 00:00  |  Presenting Author(s): Iuri Amorim Santana

      • Abstract
      • Slides

      Introduction

      Lung cancer has one of the highest lethality rates. Provide a complete diagnosis, staging and treatment in a short time frame is mandatory and impacts in clinical outcomes. There is not a standard of which is the ideal route and how long it should take, mainly in an outpatient scenario. We designed a whole pathway system to guide and timely monitoring the lung cancer (LC) patients (pct) from the registration in the service until treatment beginning.

      Methods

      This is a retrospective analysis of all consecutive pcts with LC or high-risk lung nodule on computerized tomography (CT) scan registered between January to December 2019. We evaluated indicators divided into 3 categories: performance (time to diagnostic [TTD]; time to start any treatment [TTT]; time to start adjuvant chemotherapy[TTA]); care (rate of stage III patients discussed in a tumor board [TB]; rate of multidisciplinary assessment [MA] before second cycle); and clinical outcomes (overall survival [OS] at 1 year; performance status [PS] decreasing before start treatment). Based on guidelines and quality certification programs we set goals for each indicator: we expected 75% of pcts with a TTD < 21 days; 75% of pcts with TTT <35 days and 100% of pcts with TTA <60 days. All stage III pcts must be discussed by a TB and all pts who received chemotherapy (CTx) must receive MA before the second cycle.

      Results

      Ninety-nine pts were registered, 50,5% with suspect CT-scan findings. There were 25% of pcts with a TTD < 21 days and a median of 47 days; 55,4 % had a TTT <35 days with a median of 32,5 days; and 100% had TTA <60 days with a median of 39 days. Among stage III pcts, were evaluated by a TB before start treatment and all pts who received CTx had MA before the second cycle. There was a decrease of PS in 13.6% of patients before start treatment, and 1-yeat OS rate was 78.6%.

      Conclusion

      The indicators analysis showed that patients received a multidisciplinary-based treatment and the critical point for delays was in the diagnostic period which may influences on TTT and decreasing of PS. Measures to improve performance indicators, such as integrating a navigator on the system, can optimize the flows and impact in clinical outcomes.

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