TRAIECTORIILE PACIENTILOR CU CANCER DE SAN - COMPARAREA A DOUA REGIUNI DIN FRANȚA SI ROMANIA SIMILARE CA DIMENSIUNE A POPULATIEI (RHONE ALPES SI TRANSILVANIA)

Abstract

The work presented in this article is part of a larger study that aims at comparing and putting together information about patients’ trajectories and resources allocation model, in order to suggest a more efficient and equitable way of organizing certain type of medical services within a region or even at national level. The objective of the study is to analyze the situation for beast cancer patients’ trajectories in 2 similar regions (population size) and see if similar or different conclusions related with the organization of the cancer network can be drawn, similar (or not) with those of the French colleagues analyzing the Rhone Alpes database (1).The methodology used was based on the availability for both countries and regions of (all) patients level data information, including standardized clinical and geographical information about patient and the medical facility where the patient sleeked care. Analysis was performed using the Microsoft Access data base made available for inpatient care in Romania (courtesy of the National School of Public health from Bucharest) and tracked with the help of the UPI (Unique Patient Identifier) the trajectory of the breast cancer patients (C50, World Health Organization International Classification of Diseases version 10) along the hospitals from Transylvania (16 counties) during year 2005 (January 1st, December 31st).In parallel, a literature and legislative and regulatory review made possible analysis of the existing cancer network formal organization within the Romanian health system and compare it with the results of the patients’ trajectories analysis.The results of the studies allow for two main conclusions: using similar standardized information systems to record medical activity allows comparisons of not only data, but concepts between population similar regions and trajectories of the breast cancer patients analyzed for Transylvania are a good predictor for the (re) organization of the cancer health care delivery network, especially of the resources allocation component is also taken into consideration. Keywords:Patients’ trajectory, hospitals network, breast cancer, classification system, regionLucrarea prezentata in acest articol este parte a unui studiu mai mare care are drept scop reunirea si compararea informatiilor despre traiectoriile pacientilor si modelul de alocare a resurselor, pentru a sugera un mod mai eficient si echitabil de a organiza anumite tipuri de servicii medicale intr-o regiune sau chiar la nivel national. Obiectivul de studiu este de a analiza situatia traiectoriilor pacientilor cu cancer de san in 2 regiuni similare (marimea populatiei) si a vedea daca pot fi trase concluzii similare sau diferite legate de organizarea retelelor de oncologie, similare (sau nu) cu cele ale colegilor francezi care au analizat baza de date din regiunea Rhône Alpes (1). Metodologia utilizata a fost bazata pe disponibilitatea pentru ambele tari si regiuni, a (tuturor) informatiilor privind datele la nivel de pacient, inclusiv informatiile clinice si geografice standardizate despre pacient si spitalul la care pacientul a primit ingrijiri. Analiza a fost efectuata folosind baza de date Microsoft Access existenta la nivel national continand datele pacientilor din spitalizare continua in Romania (prin bunavointa Școlii Nationale de Sanatate Publica, Management si Perfectionare in Domeniul Sanitar din Bucuresti, Romania), si urmarirea cu ajutorul Identificatorului Unic de Pacient (“Unique Patient Identifier”, UPI, IUP) a traiectoriei pacientilor cu cancer mamar (cod C50, Clasificatia Internationala a Maladiilor 10 a Organizatiei Mondiale a Sanatatii, CIM10 OMS) prin spitalele din Transilvania (16 judete) in cursul anului 2005 (1Ianuarie, 31Decembrie). Rezultatele studiilor permit doua concluzii principale: 1. folosirea sistemelor de informatica medicala standardizate si similare pentru inregistrarea activitatii medicale permite comparatia, nu numai a datelor, dar si a conceptelor intre regiunile similare ca populatie si 2. traiectoriile pacientilor cu cancer de san analizate pentru Transilvania permit o previziune buna pentru (re)organizarea retelei de oncologie, in special in conditiile in care componenta de alocare a resurselor este, de asemenea, luata in considerare. Cuvinte cheie: Traiectoria pacientilor, retea de spitale, cancer de san, sistem de clasificare, regiun