Enhancing Healthcare for Sarcoma Patients: Lessons from a Diagnostic Pathway Efficiency Analysis

SIMPLE SUMMARY: The total interval of the diagnostic pathway, which consists of the patient interval and the diagnostic interval, describes the time between the first symptom and the final diagnosis. Thus, it could be used as an efficiency marker of a healthcare system. The efficiency of the most expensive health care system in Europe, Switzerland, for bone and soft tissue sarcomas, as well as their benign representatives, has not yet been described. Sarcomas are rare and have a worse outcome than more common tumors. It is assumed that a short total interval leads to a better outcome. Finding out where to start in the total interval to achieve the greatest potential for optimization and to elicit healthcare efficiency is the goal of this study. We have done this by dividing the total interval into its components and looking at their length, as well as potential influencing factors. This revealed that the patient and secondary care interval represent bottlenecks with age, grade, localization, and size being influencing factors of the length of intervals and probability of sarcoma. ABSTRACT: Sarcomas, rare and with lower survival rates than common tumors, offer insights into healthcare efficiency via the analysis of the total interval of the diagnostic pathway, combining the patient interval (time between the first symptom and visit with a physician) and diagnostic interval (time between first physician visit and histological diagnosis). Switzerland’s healthcare system, Europe’s costliest, lacks research on treating rare conditions, like mesenchymal tumors. This study examines the total interval of the diagnostic pathway for optimization strategies. Analyzing a dataset of 1028 patients presented from 2018 to 2021 to the Swiss Sarcoma Board (MDT/SB-SSN), this retrospective analysis delves into bone sarcoma (BS), soft-tissue sarcoma (STS), and their benign counterparts. Demographic and treatment data were extracted from medical records. The patient interval accounted for the largest proportion of the total interval and secondary care interval for the largest proportion of the diagnostic interval. Age, grade, and localization could be elicited as influencing factors of the length of different components of the total interval. An increasing age and tumor size, as well as the axial localization, could be elicited as factors increasing the probability of sarcoma. The patient and secondary care interval (SCI) offer the greatest potential for optimization, with SCI being the bottleneck of the diagnostic interval. New organizational structures for care work-ups are needed, such as integrated practice units (IPU) as integral part of value-based healthcare (VBHC).