title: [Documentation Time and Effort and Associated Resources for Patients with Primary Breast Cancer from Diagnosis to End of Follow-Up - Results of a Multicentre Validation].
abstract: BACKGROUND
  Tumour documentation is essential for quality assurance of oncological therapies and as a source of reliable information about the in- and outpatient care. The documentation effort and the associated resource consumption were analysed for the example of breast cancer.
  
  
  METHODS
  The different steps in the care of patients with primary breast cancer in a standardised disease situation were defined from initial diagnosis to the end of the follow-up. After the pilot phase, a multicentre validation (n=7 centres) was performed with the support of the Federal Ministry of Health. The documentation time points were horizontally collected and analysed with regard to amount, duration and personnel expenses.
  
  
  RESULTS
  57% of the documentation costs are caused by the physicians. Regarding the different centres, documentation costs were calculated between € 352.82 and € 1 084.08 per patient from diagnosis to completion of aftercare. Non-certified centres had a reduced documentation effort and thus lower costs.
  
  
  CONCLUSIONS
  The results demonstrate the need for a reduction of the documentation effort - particularly for physicians - the most expensive profession in the health system. A quality improvement is expected from the certification with its special requirements. In this context, there is a justified demand for an adequate remuneration of the documentation effort for certified centres. Furthermore, it is necessary to reduce the number of variables for quality assurance and to define them centrally. A comprehensive multi-disciplinary documentation should be achieved. Investments in a single data set and interface enhancements of existing documentation systems should be realised.
authors.affiliation: Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Erlangen.
authors.forename: M
authors.initials: M
authors.lastname: Beckmann
authors.affiliation: Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Erlangen.
authors.forename: C
authors.initials: C
authors.lastname: Sell
authors.affiliation: Brustzentrum Bremen, Gynäkologische Klinik, Klinikum Bremen-Mitte, Bremen.
authors.forename: M
authors.initials: M
authors.lastname: Aydogdu
authors.affiliation: Universitäts-Brustzentrum Tübingen, Frauenklinik, Universitätsklinikum Tübingen, Tübingen.
authors.forename: S Y
authors.initials: SY
authors.lastname: Brucker
authors.affiliation: Universitäts-Brustzentrum Düsseldorf, Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf.
authors.forename: T
authors.initials: T
authors.lastname: Fehm
authors.affiliation: Universitäts-Brustzentrum Ulm, Frauenklinik, Universitätsklinikum Ulm, Ulm.
authors.forename: W
authors.initials: W
authors.lastname: Janni
authors.affiliation: Universitäts-Brustzentrum Ulm, Frauenklinik, Universitätsklinikum Ulm, Ulm.
authors.forename: R
authors.initials: R
authors.lastname: Kreienberg
authors.affiliation: Brustzentrum Essen-Mitte, Klinik für Senologie, Klinikum Essen-Mitte, Essen.
authors.forename: S
authors.initials: S
authors.lastname: Kümmel
authors.affiliation: Universitäts-Brustzentrum Düsseldorf, Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf.
authors.forename: M
authors.initials: M
authors.lastname: Neumann
authors.affiliation: Brustzentrum St. Marien Amberg, Frauenklinik, Klinikum Amberg, Amberg.
authors.forename: A
authors.initials: A
authors.lastname: Scharl
authors.affiliation: Gynäkologisches Zentrum Schwandorf, Krankenhaus Schwandorf, Schwandorf.
authors.forename: B
authors.initials: B
authors.lastname: Schleicher
authors.affiliation: Universitäts-Brustzentrum Tübingen, Frauenklinik, Universitätsklinikum Tübingen, Tübingen.
authors.forename: D
authors.initials: D
authors.lastname: Wallwiener
authors.affiliation: Universitäts-Brustzentrum Ulm, Frauenklinik, Universitätsklinikum Ulm, Ulm.
authors.forename: A
authors.initials: A
authors.lastname: Wöckel
authors.affiliation: Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Erlangen.
authors.forename: P A
authors.initials: PA
authors.lastname: Fasching
authors.affiliation: Universitäts-Brustzentrum Franken, Frauenklinik, Universitätsklinikum Erlangen, CCC Erlangen-EMN, Erlangen.
authors.forename: M P
authors.initials: MP
authors.lastname: Lux
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D019091:Critical Pathways / Q000191:economics* / Q000706:statistics & numerical data; D004282:Documentation / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D010820:Physicians / Q000191:economics*; D015995:Prevalence; D016526:Workload / Q000191:economics