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5 years ago

Ben RHM II - LZG.NRW

Ben RHM II - LZG.NRW

Benchmarking Regional Health Management II (Ben RHM II) ___________________________________________________________________________________________________________________________________________________________________ of the 17 regions that responded, there is a duty to notify cases of breast cancer. The differ- ence of approaches is most evident in the 3 Italian regions where notification is not obligatory in 2 of the regions. It should be noted that obligatory reporting is included as an evidence- based policy in the reference framework. Turning to treatment and care, the analysis of the responses shows that 10 of the 15 regions that responded have Integrated Care programmes and 5 regions do not have such pro- grammes. A similar number, 10, responded to say that they have Managed Care Programmes and 5 said that they have do not have these programmes. The reference framework for breast cancer includes an evidence-based policy for the developnment of Disease Management Programmes/Integrated Care and the responses show that this good practice norm has been adopted by 10 regions. Regarding the establishment of multidisciplinary Breast Units, the responses from 11 regions show that 10 of them have developed Breast Units. No information was received from 8 regions. European guidelines for quality assurance, published by EUSOMA, apply to such units but these are not applied in all regions, or partially applied along with other guidelines. The reference framework includes a number of policies regarding Breast Units. These are the establishment of specialised centres (with defined minimum number of primary thera- pies); certification of centres according to EUSOMA; establishment of internationally recog- nised performance indicators (e.g. mastectomy rates). It is not clear from the analysis of re- sponses how many regions have Breast Units that conform to all of these criteria. The responses show that, in general, all regions that responded carry out some reha- bilitation activities in different settings. However, because of difficulties in classifying the range of information given it has not been possible to give any precise summary by region of the types and an extent of rehabilitation being carried out. It is possible to say that in addition to breast reconstruction, physical therapies, lymphoedema and drug therapies are included. Socio-psychological rehabilitation is provided by 12 regions, partly by 1 region and not at all by 1 region. There was no response from 5 regions. A prosthetic fitting service is provided in 16 regions out of 17 that responded. It is not provided in 1 region and the reason given for this is the expense involved. The reference framework includes a number of interventions and policies regarding rehabilitation: psycho-social counselling; establisment of psycho-social centres; consideration of psychological factors in guidelines; improvement of psychosocial competence of health professionals; implementation of guidelines for rehabilitation; improvement of ambulant re- habilitation. - 276 -

Benchmarking Regional Health Management II (Ben RHM II) ___________________________________________________________________________________________________________________________________________________________________ It would seem from the fragmented nature of the responses to some of the questions about rehabilitation that regions in general fall short of some of the good practice requirements in this area. Monitoring of patient satisfaction regarding treatment and care is included in the analysis of responses. This shows that 10 regions out of 13 that responded do, and 3 do not, carry out such monitoring. There was no response from 6 regions.This activity is not included as such in the reference framework but patient empowerment to encourage rights of participa- tion and also access to information assessing the quality of the care provider, are two activi- ties that are included. The analysis shows that in response to a question about breast cancer being part of the political agenda, 13 regions said that prevention through mammography screening pro- grammes has currently become part of the political agenda. When this question is expanded to ask about the promotion of self-help groups as part of the political agenda, 6 regions said it is and 7 said it is not. However, in response to a further question all the regions that responded, with the exception of 3, said that self-help groups are supported (may include financial sup- port) by official instiutions in their regions. - 277 -

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