A “pay for performance” (P4P) strategy would be implemented next year to address the increasing mortality rate of breast cancer, Minister of Health and Welfare Shih Chung-liang (石崇良) said at the opening ceremony of the two-day Taipei International Breast Cancer Symposium in Taipei yesterday.
Breast cancer is the most common type of cancer among women in Taiwan, and while the five-year survival rate exceeds 95 percent when the disease is diagnosed at an early stage, overall mortality is still increasing, Shih said at the event, which was organized by the Taiwan Breast Cancer Society.
Breast cancer was the second-biggest cause of cancer deaths in women in 2023, with 2,972 deaths that year, while the standardized mortality rate of breast cancer in women has increased to 13.3 percent in 2023 from 11.1 percent in 2008, Ministry of Health and Welfare data showed.
Photo: CNA
There are differences in survival rates at different healthcare facilities, with some having a five-year survival rate of 90 percent, while some have a 76 percent rate, Shih said.
The ministry is planning to introduce the P4P model in a bid to increase the overall survival rate for people being treated for the disease, he said, adding that the program might begin in at the 70 hospitals with cancer quality certification or facilities that treat more than 50 breast cancer patients per year.
The P4P model is also known as “value-based purchasing,” offering financial incentives to healthcare providers for meeting performance criteria.
The first phase would be “Pay for Reporting,” which would require collecting information from hospitals to assess their situation, before the subsequent phases of “Pay for Improvement” and “Pay for Excellence,” he said.
A set of comprehensive quality indicators would be established — such as medical team composition, compliance with clinical treatment guidelines, and recurrence and survival rates — to assess whether treatment quality improves, with rewards for sustained improvement and good performance, he said.
The ministry has held meetings with hospitals regarding P4P, with some expressing concerns, so the issue is still being discussed, Shih said, adding that a breast cancer registry system needs to be established to gather real-time data.
On the sidelines of the event, reporters asked Shih about heated tobacco products being legally sold in Taiwan.
“Smoking is absolutely not good” for people’s health, Shih said.
However, the government must assess the health risks of smoking heated tobacco products and limit their use as it does with cigarettes, because the risk is greater if such products are imported without being regulated, he said.
The government’s policy on heated tobacco products is clear and there will be no compromise in enforcement of the law, so the tobacco companies must comply with the nicotine limits and nicotine content labeling standards, he added.
Additional reporting by CNA
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