Mapping the Diffusion and Implementation of Breast Units: Lessons Learned from the Case of Italy
Main Article Content
Abstract
The paper examines the diffusion and implementation of breast units (BUs) in Italy as a paradigm of pathology units. Through a case study methodology, the article analyses both European and Italian requirements for the identification of BUs and conducts a comprehensive census of active BUs in Italy, by reconciling data from four distinct databases. The analysis reveals variations in requirements between the national and the European level, indicating a process of adaptation while adopting European guidelines and underscoring the complexity of harmonizing BUs identification criteria. Furthermore, the census of active BUs provides an estimate of the total number of BUs in Italy and assesses adherence to the recommended population coverage standard (one breast unit per approximately 250,000 inhabitants) at the regional level in Italy. Indeed, the analysis shows geographical disparities in the diffusion of BUs across Italian regions. Additionally, this study highlights the challenge deriving from the lack of a unified national database displaying the total number of active BUs in Italy, a limitation that extends to the European context. The paper ends by offering some insights for future research in this area, emphasizing the need for standardized data collection.
Article Details
How to Cite
DALPONTE, Federica et al.
Mapping the Diffusion and Implementation of Breast Units: Lessons Learned from the Case of Italy.
Medical Research Archives, [S.l.], v. 11, n. 11, nov. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4407>. Date accessed: 09 may 2024.
doi: https://doi.org/10.18103/mra.v11i11.4407.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. Lee K soo, Chun K hong, Lee J soo. Reforming the hospital service structure to improve efficiency: Urban hospital specialization. Health Policy. 2008;87(1):41-49. doi:10.1016/j.healthpol.2007.10.003
3. Tozzi V, Longo F, Pacileo G, Salvatore D, Pinelli N, Morando V. PDTA standard per le patologie croniche: 11 ASL a confronto nella gestione della rete dei servizi per BPCO, tumore polmonare, ictus, scompenso cardiaco e artrite reumatoide. EGEA; 2014.
4. Brown BB, Patel C, McInnes E, Mays N, Young J, Haines M. The effectiveness of clinical networks in improving quality of care and patient outcomes: a systematic review of quantitative and qualitative studies. BMC Health Serv Res. 2016;16(1):360. doi:10.1186/s12913-016-1615-z
5. Skrove GK, Bachmann K, Aarseth T. Integrated care pathways—A strategy towards better care coordination in municipalities? A qualitative study. Int J Care Coord. 2016;19(1-2):20-28. doi:10.1177/2053434516649777
6. Hussain M, Malik M. Prioritizing lean management practices in public and private hospitals. J Health Organ Manag. 2016;30(3):457-474. doi:10.1108/JHOM-08-2014-0135
7. Tozzi VD, Morando V, Ferrara L. Can Integrated Practice Units work without the set-up of Accountable Care Organisations? Lessons learnt from the Breast Units’ experiences in Italian NHS. Int J Integr Care. 2018;18(s2):383. doi:10.5334/ijic.s2383
8. Jahmani K, Fadiya SO, Abubakar AM, Elrehail H. Knowledge content quality, perceived usefulness, KMS use for sharing and retrieval: A flock leadership application. VINE J Inf Knowl Manag Syst. 2018;48(4):470-490. doi:10.1108/VJIKMS-08-2017-0054
9. Karamitri I, Talias MA, Bellali T. Knowledge management practices in healthcare settings: a systematic review: Knowledge Management in Healthcare: A Systematic Review. Int J Health Plann Manage. 2017;32(1):4-18. doi:10.1002/hpm.2303
10. Cook D, Thompson JE, Habermann EB, et al. From ‘Solution Shop’ Model To ‘Focused Factory’ In Hospital Surgery: Increasing Care Value And Predictability. Health Aff (Millwood). 2014;33(5):746-755. doi:10.1377/hlthaff.2013.1266
11. European Commission. Joint Research Centre. Report of a European Survey on the Implementation of Breast Units: ECIBC–Supporting Information for Breast Cancer Care Policies and Initiatives. Publications Office; 2017. Accessed March 13, 2023. https://data.europa.eu/doi/10.2760/070213
12. European Commission, ed. European Guidelines for Quality Assurance in Breast Cancer Screening and Diagnosis. 4th ed. Office for official publications of the European Communities; 2006.
13. Europa Donna. Europa Donna 2020 Survey. The current state of breast services in Europe. Published online 2020. Accessed March 13, 2023. https://www.europadonna.org/wp-content/uploads/2021/11/Europa-Donna-BC-Survey-september-2020.pdf
14. Yin RK. Case Study Research: Design and Methods. 5. edition. SAGE; 2014.
15. Yin RK. Case Study Research: Design and Methods. 2nd ed. Sage Publications; 1994.
16. Denzin NK, Lincoln YS, eds. Handbook of Qualitative Research. 2nd ed. Sage Publications; 2000.
17. Ferrara L, Zazzera A, Tozzi VD. Managing Chronic Conditions: Lessons Learnt from a Comparative Analysis of Seven Years’ Policies for Chronic Care Patients in Italy. Int J Integr Care. 2022;22(1):4. doi:10.5334/ijic.5686
18. Europa Donna Italia. Le Breast Unit in Italia. Accessed March 13, 2023. https://europadonna.it/ambito/breast-unit/monitoraggio/
19. Senonetwork. Elenco Centri di Senologia. Accessed March 13, 2023. https://www.senonetwork.it//it/centri-senologia/elenco-centri-di-senologia/1-4118-1-
20. Breast Centres Certification. Certified Breast Centres. Accessed March 13, 2023. https://www.breastcentrescertification.com/breastcentrescert.php
21. Agenas. PNE - Programma Nazionale Esiti. Accessed March 13, 2023. https://pne.agenas.it/
22. Ferrara L, Tozzi VD, Zazzera A. Le unità specialistiche di patologia: modelli e sistemi di gestione delle Breast Unit in Italia. In: Rapporto OASI 2020. Egea; 2020:477-512.
23. Eusoma. The requirements of a specialist breast unit. Eur J Cancer. 2000;36(18):2288-2293. doi:10.1016/S0959-8049(00)00180-5
24. Wilson ARM, Marotti L, Bianchi S, et al. The requirements of a specialist Breast Centre. Eur J Cancer. 2013;49(17):3579-3587. doi:10.1016/j.ejca.2013.07.017
25. Biganzoli L, Cardoso F, Beishon M, et al. The requirements of a specialist breast centre. The Breast. 2020;51:65-84. doi:10.1016/j.breast.2020.02.003
26. European Parliament. European Parliament Resolution on Breast Cancer in the European Union (2002/2279(INI)).; 2003.
27. European Parliament. European Parliament Resolution on Breast Cancer in the Enlarged European Union.; 2006.
28. Ministero della Salute. Linee di indirizzo sulle modalità organizzative ed assistenziali della rete dei Centri di Senologia. Published online 2014.
29. Europa Donna. Il tumore al seno. Breast Unit. Published online 2020. Accessed March 13, 2023. https://europadonna.it/wp-content/uploads/2020/07/Manuale-Breast-Unit-2020.pdf
30. Ferrara L, Otto M, Aapro M, et al. How to improve efficiency in cancer care: Dimensions, methods, and areas of evaluation. J Cancer Policy. 2022;34:100355. doi:10.1016/j.jcpo.2022.100355
31. Bombard Y, Baker GR, Orlando E, et al. Engaging patients to improve quality of care: a systematic review. Implement Sci. 2018;13(1):98. doi:10.1186/s13012-018-0784-z
32. Simpson EL. Involving users in the delivery and evaluation of mental health services: systematic review. BMJ. 2002;325(7375):1265-1265. doi:10.1136/bmj.325.7375.1265
33. Robertson AG, Robertson C, Soutar DS, Burns H, Hole D, McCarron P. Treatment of Oral Cancer: The Need for Defined Protocols and Specialist Centres. Variations in the Treatment of Oral Cancer. Clin Oncol. 2001;13(6):409-415. doi:10.1053/clon.2001.9303
34. National Institute for Clinical Excellence. Guidance on Cancer Services – Improving Outcomes in Head and Neck Cancers – The Manual. Published online 2004.
35. NHS Executive. Guidance on commissioning cancer services: improving outcomes in upper gastro-intestinal cancers. Published online 2001.
36. Langhorne P, Ramachandra S, Stroke Unit Trialists’ Collaboration. Organised inpatient (stroke unit) care for stroke: network meta-analysis. Cochrane Stroke Group, ed. Cochrane Database Syst Rev. Published online April 23, 2020. doi:10.1002/14651858.CD000197.pub4
37. Directorate-General for Health and Food Safety, European Commission. European Reference Networks. Published March 8, 2023. Accessed September 7, 2023. https://health.ec.europa.eu/european-reference-networks_en