Authors (including presenting author) :
Choy WY1(1) Chan STF(2), So WSV(3), Chan KM(4), Sheung LM(5) Kwok SM(6), Ng PS(7)
Affiliation :
(1-7) Surgery (Breast Care), Princess Margaret Hospital
Introduction :
Breast cancer is the commonest cancer among females in Hong Kong. It is the third leading cause of cancer deaths among females in Hong Kong after lung and colorectal cancers. In 2020, a total of 751 women died from breast cancer, accounting for 12.2% of all cancer deaths in females. Time to surgery, chemotherapy and radiotherapy have an impact on outcomes.
However, the fifth wave of the coronavirus disease-19 (COVID-19) epidemic broke out in January 2022. It has posed significant pressures on Hong Kong healthcare systems, affected medical operations, raising concern that related care being delayed. In view of the development of COVID-19, the Hospital Authority (HA) has expanded the service scope of some of the Public-Private Partnership (PPP) programmes including of the delivery services such as breast cancer surgery to cover all eligible breast cancer patients, so that affected patients can be treated as early as possible.
Objectives :
To divert some breast cancer patients to receive breast cancer operative service at Private Hospitals, so as to alleviate the demand in public healthcare service.
Methodology :
An eligible patient who is assessed by Surgery Department of designated HA hospitals. They may choose to receive a specific breast cancer operative service provided by participating Private Hospitals. Cancer Case Manager (CCM) needs to explain the process to eligible patients and obtain the consent. CCM also need to prepare document, clinical records and connect between private hospital and HA hospital.
Each referred patient being accepted by private hospital, they will receive at least one pre-operative consultation, specific breast cancer operation with inpatient stay, at least one post-operative consultation and all types of peri-operative care including essential and related diagnostic blood tests and imaging investigations, medications, nursing and allied health care, wound and drain care and peri-operative physiotherapy, etc. The participating patients only need to pay the same HA standard fees and charges.
Result & Outcome :
Total 141 breast cancer patients were done breast cancer operation at Princess Margaret Hospital in 2022 and 38 breast cancer patients were referred to private hospital for breast cancer operative service during the peak of the COVID-19 epidemic (February to December 2022).
100% of breast cancer patients were receiving first definitive treatment of surgery after first investigation for positive diagnosis in 60 days and achieved the key performance indicators (KPI).
97.37% (37 cases) of breast cancer patients satisfied PPP programmes because they could have surgery sooner. However, some patients were concerned about post-operative complication care due to late of follow up in private and the far away location. Most of them want to go back to HA hospital for follow. Only one of breast cancer patient showed neutral comment on PPP programmes.
