Transcript Folie 1 - Cancer Care Ontario

Recent trends in cancer care in Germany:
DMP, integrated care, certification
Ronald Walshe, MD, Dipl.-Kfm.
CFO, Center for Integrated Oncology, Cologne, Germany
Disease management program (DMP)
breast cancer in Germany (1)
Rationale and incentives
Medical objectives
Organizational requirements
Detailed initial and follow-up documentations
Incentives for patients and providers
Disease management program (DMP)
breast cancer in Germany (2)
Participation: ~40 hospitals and ~1000 officebased gynecologists in North Rhine
First results (2006):
•More needle biopsies, breast preserving surgeries
• High percentage of axillar lymphadenectomies
• Fewer post surgery radiotherapies (?)
Outlook / morbidity based risk compensation
Integrated cancer care in Germany:
CIO Cologne (1)
Financing: SHI Modernization Act (2004)
March 2007: 3.671 contracts, € 663,700,000
CIO Cologne: 1 university hospital, 120 officebased physicians, 3 large sickness funds (AOK,
BARMER, IKK (65% of population))
Contracts for lung, colorectal and prostate cancer
Integrated oncology (3): Departments and institutes
Office-based physicians
Interdisciplinary oncological outpatient unit
Medical
Oncology
Surgery
Radiology
Radiotherapy
Pulmonology
Nuclear medicine
Thoracic
surgery
Gastroenterol.
Pathology
Orthopedics
Urology
Transfusion medicine
Dermatology
Gynecology
Pediatric oncology
Psychooncology / Haus LebensWert
Interdisciplinary diagnostics, therapy and after care
Palliative care
Cure
IGKE
Pharmacy
KKSK
After
care
ZFVK
Mildred Scheel
Haus
Hospice
Rehab
Scientific
Evaluation
Integrated cancer care in Germany:
CIO Cologne (2)
Joint development of guidelines and clinical
pathways (providers and payers)
Reimbursement: Stage based global fee
payments
Diagnostics
Surgery, radiotherapy, chemotherapy
After care
Palliative care
Integrated cancer care in Germany:
CIO Cologne (3)
Global fees for the first 12 months of treatment
Lung (NSCLC)
Colon
Rectum
€ 9.000 - € 20.000
€ 8.800 - € 12.500
€ 10.600 - € 15.700
Certification of cancer centers
Breast, colorectal, prostate cancer centers
German Cancer Society (Onkozert), Physicians´
Chambers, TÜV, KTQ, German Society of
Hematology and Oncology, European
organizations
-> highly heterogenous processes and results
Conclusion and outlook
DMP
Integrated care
Certification