Announcements

The increasing incidence and prevalence of cancer, particularly breast cancer, presents substantial challenges for the Austrian healthcare system. The current hospital-centred care delivery model contributes to escalating costs and suboptimal resource utilisation.

A comprehensive analysis of cancer care models across six European countries (Austria [AT], Germany [DE], Denmark [DK], Sweden [SE], Netherlands [NL], Belgium [BE]) was conducted through structured literature review, expert consultations (n=17), and data synthesis, focusing specifically on breast cancer care. Analysis of healthcare infrastructures and cross-sectoral care approaches throughout the patient journey identified three distinct models: centralised specialist models (AT, BE, DK) characterised by highly specialised centres with strict volume requirements; decentralised care (DE) featuring distributed hospital structures in the in- and outpatient setting; and network-based integrated care (NL, SE) combining specialist centres with regional care delivery. These models demonstrate considerable variations in their utilisation of inpatient, outpatient, and home-based care services. While these models reflect varying degrees of centralisation and specialisation, they all aim to ensure high-quality care through regulation, accreditation and collaboration, with countries combining elements of different models based on their national cancer strategy and healthcare infrastructure.

For Austria, implementing a gradual transition towards a more decentralised or network-based model could potentially alleviate pressure on hospital resources while enhancing quality of care. However, successful implementation necessitates appropriate infrastructure, qualified healthcare professionals, and effective cross-sectoral coordination. Key challenges include addressing workforce shortages and overcoming fragmented data integration across healthcare sectors.

With approximately one in five Austrian adults affected by mental illness annually, primarily depression (10%), anxiety disorders (7%), and substance use disorders (12%), screening in primary care settings could help identify and treat affected individuals early. Based on systematic reviews and evidence-based guidelines, this report analyses the evidence for mental health screening in primary care, identifies available screening tools, and discusses the requirements for implementing screening.

On average, one in five women suffer from a mental illness during the perinatal period (pregnancy up to 1 year after birth. So far, it has been unknown how many women claim mental health services during this period. The analysis of pseudonymised insurance data revealed that around 20% of women in Austria who gave birth in 2017 and 2018 used at least one of five examined mental health services during the perinatal period. However, very few specialised perinatal mental health services are available in Austria, with regional disparities. The quality of existing services should be evaluated, and gaps in care need to be closed.

This update report assesses three alternative treatments to radical therapies for localised prostate cancer (PCA): irreversible electroporation (IRE) uses electrode needles to target and destroy carcinoma tissue; stereotactic radiation therapy (SBRT) and proton therapy (PT) are forms of external beam radiation therapy, SBRT delivers high dose radiation in fewer fractions than conventional or moderate fractionation radiation, while PT delivers high-dose ionizing radiation with great precision.

Point of care tests (POCTs) for troponin (Tn) and D-Dimer enable rapid diagnostics near patients. Tn-POCTs are used when there is a suspicion of acute coronary syndrome (ACS) and D-Dimer-POCTs are used when there is a suspicion of venous thromboembolism (VTE).

The aim of this report is to evaluate the clinical utility of the two POC diagnostics, D-Dimer and troponin, in primary care.

Publication: HTA Project Report No. 124, 1. Update 2024: https://eprints.aihta.at/1524/
Contact: Claudia Wild