[Value-based health care for prostate cancer centers-implementation of specific key performance indicators using a Balanced Scorecard]

Prostate cancer (PC) is the most common cancer in men in Germany, accounting for 29% of all malignancies. Since it cannot be prevented, improved diagnostics and therapy are required. Within the framework of so-called value-based healthcare, the Balanced Scorecard (BSC) has been established as a measurement instrument for achieving such improvements.

The aim of the present study was to develop a BSC for the treatment of localized prostate cancer.

BSCs assess the performance of healthcare organizations across multiple dimensions: financial, patient and referrer, process, and learning and development perspectives. The goal was to identify key performance indicators (KPIs) for each perspective. In addition, a novel disease and outcomes perspective was established specifically for prostate cancer. A systematic literature review conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines across multiple databases identified relevant KPIs.

A PC-specific BSC was developed encompassing KPIs for the four classical perspectives as well as a novel disease and outcomes perspective, incorporating parameters from the certification process of the German Cancer Society (GCS; Deutsche Krebsgesellschaft) and the International Consortium for Health Outcome Measurement (ICHOM). Among other elements, the process perspective includes KPIs relating to the training of resident physicians, and the learning and development perspective contains metrics for the structured training of radical prostatectomy.

The BSC encompasses diverse perspectives for prostate cancer centers and ensures manageable indicators. It enables value creation in the sense of Porter's "full cycle of care" through the systematic capture of economic, personnel-related, and medical key figures. In particular, it contains KPIs for the structured training of surgeons and metrics of the GCS that have been shown to demonstrably improve patient outcomes.