Performance indicators for monitoring the integrated care pathway of patients with colorectal cancer: the E.Pic.A. project

Background: Given limitations in economic resources, achieving sustainability in healthcare is an increasingly important issue driving policy decisions. Colorectal cancer (CRC) is a frequent oncological diagnosis with an incidence that is expected to increase, making the efficient utilisation of resources a major priority for its diagnosis and treatment. To assess potentially inappropriate utilisation of services in the integrated care pathway of patients with malignant CRC, a series of key performance indicators (KPIs) have been developed by a multidisciplinary panel of the E.Pic.A. project (Economic Appropriateness of an Integrated Care Pathway). Methods: The KPIs identified had to comply with criteria of reliability, representativeness, accessibility and operativity. A definition is provided for each of the KPIs, along with the methodology used to calculate it and a reference target. Results: Eight KPIs were identified that can measure inadequacies of services provided in the diagnostic and treatment pathways for CRC: four for instrumental diagnostics, three for surgery and one for oncologic therapy. Conclusions: Use of the methodology described can help payors to obtain detailed information on inappropriate and wasteful use of healthcare resources, which would then permit their reallocation for interventions with higher value for patients with CRC and other pathologies. (HTA & Market Access, Oncology)