Clinical and Translational Oncology

, Volume 10, Issue 4, pp 213–218 | Cite as

Implementation of a comprehensive cancer plan. A health planning experience

  • José Expósito Hernández
  • Carmen Domínguez Nogueira
  • Carmen Escalera de Andrés
Special Article
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Abstract

Here we describe the working method used to implement an Integrated Cancer Health Plan in Andalusia (Spain) and to set out some of the lines of work for improving quality of care and health network planning.

Four main initial considerations were made: (1) work must be centred on patients and respect for their autonomy; (2) cancer requires action at every healthcare level; (3) integration of expert professionals is to be encouraged; and (4) relevant information and data should be systematically used for planning. Two operative approaches were also established: structured participation and evidence-based healthcare.

This methodology was used in various planning programmes, largely in relation to healthcare resources. In this article, as examples, we describe the development of two types of programmes: one for radiotherapy equipment and another for the management of lymphoedema in breast cancer patients.

Analysis of results obtained against cancer is always controversial. It is necessary to review the healthcare structure used in terms of effectiveness and excellence. Comprehensive or integrated health plans are a useful model for a wide-ranging and multi-level approach to cancer. The structured and real participation of experts and an evidence-based healthcare strategy proved very useful in this public health planning experience.

Keywords

Cancer Comprehensive health plan Evidence Operational participation 
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References

  1. 1.
    IARC (2004) Cancer incidence in five continents, Vol VIII. IARC scientifique publication, LyonGoogle Scholar
  2. 2.
    Organización Mundial de la Salud (2002) Programas nacionales de lucha contra el cáncer. World Health Organization, GenevaGoogle Scholar
  3. 3.
    Herbst RS, Bajorin DF, Bleiberg H et al (2006) Clinical Cancer Advances 2005: major research advances in cancer treatment, prevention, and screening. A report from the American Society of Clinical Oncology. J Clin Oncol 24:190–205PubMedCrossRefGoogle Scholar
  4. 4.
    Doll R, Peto R (1989) Las causas del Cáncer. Salvat Editores, BarcelonaGoogle Scholar
  5. 5.
    Church TC, Ederer F, Mandel JS et al (2002) RE: all-case mortality in randomized trials of cancer screening. J Natl Cancer Inst 94:861–870PubMedGoogle Scholar
  6. 6.
    Smith TJ, Hillner BE (2001) Ensuring quality cancer care by the use of clinical practice guidelines and critical pathways. J Clin Oncol 19:2886–2897PubMedGoogle Scholar
  7. 7.
    Ahmedzai S, Walsh D (2000) Palliative and modern cancer care. Semin Oncol 27: 1–6.PubMedGoogle Scholar
  8. 8.
    Albert WM, Bepler G, Hazelton T et al (2003) Lung Cancer Guidelines. Practice Organization. Chest 123:332S–337SCrossRefGoogle Scholar
  9. 9.
    Pilnick A, Dinwall R, Starkey K (2001) Disease management: definitions, difficulties and future directions. Bull World Health Organ 79:755–763PubMedGoogle Scholar
  10. 10.
    Conill AM, Horowitz DA (1999) Disease management: origins, basic concepts and practical considerations. Semin Med Pract 2:4–12Google Scholar
  11. 11.
    (2003) Une mobilisation nationale tous ensemble. Ministère de la Santé, de la Famille et des personnes handicapèesGoogle Scholar
  12. 12.
    (2000) El plan de Cáncer del NHS. Un plan de inversión. Un plan de reforma Department of Health of United Kingdom. Ministerio de Sanidad y Consumo, MadridGoogle Scholar
  13. 13.
    Generalitat de Catalunya. Departament de Sanitat i Seguretat Social (2001) Plan Director de Oncología en Cataluña. Institut Catalá de OncologíaGoogle Scholar
  14. 14.
    Cancer Care Ontario (2005) Ontario Cancer Plan: 2005 Progress Report. Cancer Care Ontario, TorontoGoogle Scholar
  15. 15.
    National Board of Health (2005) National Cancer Plan II Denmark. National Board of Health, CopenhagenGoogle Scholar
  16. 16.
    Welch P, Bergsten C, Cutler C et al (2002) Disease management practices of health plan. Am J Manag Care 8:353–361PubMedGoogle Scholar
  17. 17.
    Ortún Rubio V (2003) Gestión Clínica y sanitaria. De la práctica diaria a la academia, ida y vuelta. Masson, BarcelonaGoogle Scholar
  18. 18.
    (2004) III Plan de Calidad. Consejería de Salud. Junta de Andalucía. Consejería de Salud, SevillaGoogle Scholar
  19. 19.
    Junta de Andalucía. Consejería de Salud (2002) Plan Integral de Oncología 2002–2006. Junta de Andalucía. Consejería de Salud, SevillaGoogle Scholar
  20. 20.
    Eddy DM (1993) Three Battles to watch in the 1990s. JAMA 270:520–526PubMedCrossRefGoogle Scholar
  21. 21.
    Muir Grey JA (1997) Evidence-based health care. How to make health policy and management definition. Churchill Livingstone, New YorkGoogle Scholar
  22. 22.
    Mckibbon A, Eady A, Marks S (1999) PDQ evidence-based principles and practice. BC Decker Inc, Hamilton, OntarioGoogle Scholar
  23. 23.
    Farquhar CM, Stryer D, Slutsky J (2002) Translating research into practice: the future ahead. Int J Quality Health Care 14:233–249Google Scholar
  24. 24.
    Vulto A, Louwman M, Rodrigus P, Coebergh JWW (2006) Referral rates and trends in radiotherapy as part of primary treatment of cancer in South Netherlands, 1988–2002. Radiother Oncol 78:131–137PubMedCrossRefGoogle Scholar
  25. 25.
    Cabrera Roldán P (2007) Variabilidad en la práctica radioterápica en los centros hospitalarios de Andalucía. Proyecto VARA [tesis doctoral]. Universidad de Granada, GranadaGoogle Scholar
  26. 26.
    Dixon P, O’sullivan B (2003) Radiotherapy quality assurance: time for everyone to take it seriously. Eur J Cancer 39:423–429PubMedCrossRefGoogle Scholar
  27. 27.
    Kehoe T, Rugg L-J (1999) From technical quality assurance of radiotherapy to a comprehensive quality of service management system. Radiother Oncol 51:281–290PubMedCrossRefGoogle Scholar
  28. 28.
    Leer JWH, McKenzie AL, Scalliet P, Thwaites DI. Practical guidelines for the implementation of quality systems in radiotherapy. ESTRO Publications. ESTRO (Physics) BookletsGoogle Scholar
  29. 29.
    Junta de Andalucía (2002) Consejería de Salud. Proceso Asistencial Integrado de Cáncer de Mama. Junta de Andalucía, Consejería de Salud, SevillaGoogle Scholar
  30. 30.
    Kissin MW, Querci della RG, Easton D, Westbury G (1986) Risk of lymphoedema following the treatment of breast cancer. Br J Surg 73:580–584PubMedCrossRefGoogle Scholar
  31. 31.
    Mirolo BR, Bunce IH, Chapman M et al (1995) Psychosocial benefits of postmastectomy lymphedema therapy. Cancer Nurs 18:197–205PubMedCrossRefGoogle Scholar
  32. 32.
    (2003) Lymphedema (PDQ): Supportive care. Version 10.2003. http://www.cancer.gov
  33. 33.
    Sitzia J, Woods M, Hine P et al (1998) Characteristics of new referrals to twenty-seven lymphoedema treatment units. Eur J Cancer Care (Engl) 7:255–262CrossRefGoogle Scholar
  34. 34.
    Veronesi U, Galimbeti V, Mariani L et al (2005) Sentinel node biopsy in breast cancer: early results in 953 patients with negative sentinel node biopsy and no axillary dissection. Eur J Cancer 41:16–22Google Scholar
  35. 35.
    (2003) Acords del grup de traball de cirugia del cancer de mama en relació al procediment de biópsia selectiva del gangli sentinell. Server Catalá de la Salut. OctoberGoogle Scholar
  36. 36.
    Recht A, Edge SB, Solin LJ et al for the American Society of Clinical Oncology (2001) Postmastectomy radiotherapy: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol 19:1539–1569PubMedGoogle Scholar
  37. 37.
    Bailar JC, Smith E (1986) Progress against cancer? N Engl Med 314:1226–1232Google Scholar
  38. 38.
    Boyle P, d’Onofrio A, Maisonneuve P et al (2003) Measuring progress against cancer in Europe: has the 15% decline targeted for 2000 come about? Ann Oncol 14:1312–1325PubMedCrossRefGoogle Scholar
  39. 39.
    Coleman MP, Gatta G, Verdecchia A et al for the EUROCARE Working Group. EUROCARE-3 summary: cancer survival in Europe at the end of the 20th century. Ann Oncol 14:128–149Google Scholar
  40. 40.
    Boyle P, Autier P, Bartelink H et al (2003) European Code Against Cancer and scientific justification: third version. Ann Oncol 14:973–1005PubMedCrossRefGoogle Scholar
  41. 41.
    Consejería de Salud (2002) Procesos Asistenciales Integrados. Junta de Andalucía. Consejería de Salud, SevillaGoogle Scholar
  42. 42.
    Expósito J (ed.) El trabajo de gestión desde una Dirección Médica. Los profesionales, las prácticas y los gestores. GranadaGoogle Scholar
  43. 43.
    Bonfill X (2000) Atención sanitaria basada en evidencias. Apuntes para los partidarios de impulsarla. Saned-Novartis, MadridGoogle Scholar

Copyright information

© Feseo 2008

Authors and Affiliations

  • José Expósito Hernández
    • 1
  • Carmen Domínguez Nogueira
    • 1
  • Carmen Escalera de Andrés
    • 2
  1. 1.Plan Integral de Oncología Unidad de investigaciónH.U. Virgen de las NievesGranadaSpain
  2. 2.Andalusian Health ServiceHealth Care General CoordinationAndalusiaSpain

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