gms | German Medical Science

Background: Breast cancer care is one of the many areas of health care that have been affected by the ongoing COVID-19 pandemic. Challenges in providing optimal care include protecting immunosuppressed patients, minimizing staff exposure, and distributing resources to prevent further strain in health care. Responses to these challenges – such as delays in breast cancer screenings and changes to health care services – have led to concerns of disease progression, worse overall outcomes, and suboptimal supportive care for breast cancer patients receiving treatment during the pandemic.

Research questions and study aim: The aim of this exploratory study is to identify changes related to the COVID-19 pandemic in the care experience of patients with breast cancer. How does the inpatient experience of breast cancer patients differ between patients who were treated before and during the pandemic?

Methods: The research questions will be explored using repeated cross-sectional data from 2018–2021 of a large standardized survey of patients who underwent breast cancer surgery in one of 85 certified breast cancer centers in North Rhine-Westphalia, the most populous federal state in Germany. Preliminary comparisons of patient survey data from 2018–2020 indicate moderate differences in patients’ assessment of their inpatient stay. In 2020 for example, more negative evaluations of hospital services, support, information needs, and communication with staff are observed in comparison with previous years.

Data is currently being collected for 2021 for patients who have received treatment in a certified breast center between February 1 and July 31. Repeated cross-sectional analyses will be used to identify temporal differences in patient assessments of their inpatient stay (i.e. hospital services, interaction quality with staff, psychosocial information needs, and overall patient satisfaction) and in patient health outcomes (cancer stage, quality of life). Multilevel regression models will be conducted to examine the influence of the pandemic on patient evaluation of care, adjusting for hospital factors, patient clinical and sociodemographic characteristics, and patient’s previous experience with a coronavirus infection or vaccination. Data from 2020 and 2021 will also provide insights into possible differences in breast cancer care at the onset of the pandemic in Germany and one year later.