gms | German Medical Science

Background: Research shows that performance of hospitals and surgeons are basic, important and independent factors influencing prognostic patterns and cost efficiency of the surgical treatment of colorectal cancers. "Qualitätsoffensive Darmkrebs" is an integrated care model to figure out factors influencing the prognosis and quality of life of the patients with colorectal cancer surgery. To achieve this aim, regional networks of hospitals and specialized physicians in their own practices have been settled upon an initiative of Techniker Krankenkasse (TK), a German Statutory Health Insurance, and of the hospital of the university of Erlangen. A defined benchmarking process describes the quality of processes and outcomes.

Methods: Data on treatment processes and outcomes of colorectal cancer surgery are documented in a standardised way (i.e. previous treatments, kind of surgical regime, histopathological findings, adjuvant therapy, follow-up examinations, others). Targets are defined (i.e. percentage of pre-surgery histological confirmed carcinomas, postoperative complications, percentage of R0-resections, others) and measured by an independent data trust centre. Results are offered to the participating hospitals in a complex, multi-step benchmark system. Hospitals receive results in de-anonymous form concerning their own results, in anonymous form for all other participating hospitals. All hospitals discuss the results in structured dialogues. Results of both, the benchmark system and the structured dialogues, are also offered to patients: clear and understandable information is created on the basis of consented discussions among all participating hospitals.

Conclusion and Discussion: With the present model of integrated care 'Qualitätsoffensive Darmkrebs' TK and participating hospitals perform a first step to more transparency and with that to more quality in colorectal cancer surgery. The outcomes and experiences of this project should be used in future to bring into routine similar and adequate structures in the treatment of other diseases.