Treatment Navigation in Breast Cancer Management: Process Cost Analysis Based on German Case Studies

Area of Science:

• Oncology
• Healthcare Management
• Health Economics

Background:

• Rising breast cancer incidence and complex treatments are shifting care to outpatient settings, burdening providers.
• Treatment navigators can improve efficiency and reduce physician workload in oncology care.
• This study assesses the economic impact of task delegation in German outpatient breast cancer care.

Purpose of the Study:

• To evaluate the economic effects of task delegation from the healthcare provider's perspective in German outpatient breast cancer care.
• To quantify potential cost and time savings through task delegation to non-physician personnel.

Main Methods:

• A three-step approach: identification, quantification, and evaluation of resources in outpatient breast cancer care.
• Micro-costing and process analysis to capture resource use.
• Structured interviews with physicians to quantify service duration and delegation potential; personnel costs calculated using German EBM standards.

Main Results:

• Eleven service categories and 40 individual tasks were identified.
• Full delegation potential (100%) was observed for ECGs, lab diagnostics, and medication administration.
• Highest time and cost savings were found in patient counseling, monitoring, supportive measures, and disease management program consultations.

Conclusions:

• Significant heterogeneity exists in delegation practices and efficiency gains across practices, influenced by organizational structure and staff qualifications.
• Legal and financial frameworks in Germany support delegation, but practical implementation is inconsistent.
• Delegation to treatment navigators shows substantial potential for improving efficiency and patient-centered care, especially with increasing patient numbers and oral therapies.