P0213 Effects of multidisciplinary care on survival of breast cancer: Results from a national cohort study

Abstract

Background In view of the increasing incidence of and mortality from breast cancer in Taiwanese women, we explored the effects of implementing multidisciplinary team (MDT) care on breast cancer survival. Methods Data were obtained from the Taiwan Cancer Registry and National Health Insurance Research Database, for patients who were first diagnosed with breast cancer between 2005 and 2008. Patients receiving MDT treatment were allocated to the intervention group (n = 6466), and those without MTD treatment were allocated to the control group (n = 16,987). Subsequently, to avoid selection bias of participating in MDT care, we used a propensity score to estimate the likelihood of participating in MDT care for each patient. Finally, Cox proportional hazards model was used to analyze the effects of MDT treatment on breast cancer patients’ survival. We used the propensity score as the control variable in Cox proportional hazards model. Findings Mortality in the MDT group was 0.84 (95% confidence interval 0.77–0.92) times that of the control group. Breast cancer survival was also significantly influenced by age, insured income, urbanisation of residence area, other catastrophic illness, Charlson comorbidity index (CCI), cancer stage, and surgeon service volume. MDT treatment significantly improved survival among patients who were between 55 and 64 years of age, and in patients with a severe comorbidity (CCI ⩾ 6). Interpretation MDT intervention significantly increased breast cancer survival rate, which shows that MDT policy enhances the quality of breast cancer patient care.