Effects of Multidisciplinary Team Care on Survival of Newly Diagnosed Breast Cancer Patients: An Example of 2000-2008 Breast Cancer Cohort in Taiwan

Wednesday, 24 July 2013

Pi-Ching Hsieh, RN, PhD
Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
Shih-Fan Kan, MS
Building of Clinical Research, Taiwan Society of Coloproctology, Taiepi, Taiwan, Taiwan
Hui-Fang Su, RN, PhD
Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taiepi, Taiwan

Learning Objective 1: The learner will be able to understand the trend of implemetation of multidisciplinary care on survival of newly diagnosed breast cancer patients in Taiwan.

Learning Objective 2: The learner will be able to the effects of multidisciplinary team care on survival of newly diagnosed breast cancer patients in Taiwan.

Purpose: To examine the prevalence of newly diagnosed breast cancer patients who were enrolled in multidisciplinary team care within one-year, and to evaluate the effect of multidisciplinary team care on survival in a population-based cohort of patients with breast cancer in Taiwan.

Methods: A retrospective cohort study design was conducted by using the population-based data in National Health Insurance Research Database between 1997- 2009 in Taiwan. 50,776 patients were enrolled in 2000 to 2008 breast cancer cohort. Those patients were observed through the end of 2009. Logistic regression was used to estimate the change of prevalence of patients received multidisciplinary team care trends in 2000-2008. Cox proportional-hazards model was used to obtain the hazard ratios for the effects of multidisciplinary team care, with adjustment for propensity scores associated with survival.

Results: Overall 42,553(83.81%) patients received multidisciplinary team care. There were significantly increased in the prevalence of patients received multidisciplinary team care in 2000 to 2008 breast cancer cohort. After adjusting for the propensity scores, patients who received multidisciplinary team care had a lower risk of death (HR = 0.88; 95% CI = 0.80-0.98; p= 0.02) than those cared only by surgeon.

Conclusion: The prevalence of breast cancer patients received multidisciplinary team care increased gradually and multidisciplinary team care could improve survival of breast cancer patients. The results can be the references for policy making, practice and future studies. The multidisciplinary team care model can be applied to other cancers for improving the quality of cancer care.