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[Quality and the profit situation in ambulatory radiotherapy]
1Klinik für Strahlentherapie, Städtische Krankenanstalten, Krefeld.
Background:
Increasing demands of quality assurance and growing complexity of the concepts of radiotherapy planning produce increasing costs. These costs, on the other hand, cannot be got back from the paying institutions, because, in general, treatment sessions are paid in a lump sum. Using examples from everyday's practice, it will be shown, in which range levels of quality have an influence on profit.
Method:
For 4 frequent indications for curative radiotherapy: NSCLC, radiotherapy after breast-conserving operation for breast cancer, cancer of the hypopharynx and cancer of the uterine cervix, treatment plans on 3 different quality levels have been created. For each treatment step, times in minutes have been measured and costs calculated according to staff, machines, and rooms.
Result:
Rising quality levels implies, in general, lowering the profit.
Conclusions:
Radiotherapists have to define in their workshops, which quality level is tolerable, essential, desirable or an option for the future. The single radiotherapist, then, has to decide, on what quality level he is able to work, and which radiotherapy techniques he cannot afford to offer in general or at certain times. The professional organisations have the difficult task to fight for a level of reimbursement allowing the further evolution of our profession.