Assessing and strengthening the performance of cardiovascular and cancer care pathways Co-creating resilient and person-centred systems in the wake of COVID-19

The COVID-19 pandemic revealed vulnerabilities in health systems’ ability to ensure access to and quality of care for people living with cardiovascular conditions and cancer during crises. Applying a whole-system approach, this thesis aims to address two main research questions: I) How can the impact of shocks on healthcare delivery for people living with cardiovascular diseases and cancer be monitored through performance measurement and a care pathway approach?; II) How can the performance of cardiovascular and cancer care pathways be strengthened to promote more resilient and person-centred healthcare delivery?
Building on a major global health crisis, this thesis combines data-driven insights in Part I with a collaborative development approach in Part II. The performance indicators identified in Part I, through scoping reviews, show variable depth across stages of the care pathways, lack of standardisation and disaggregated information, constraining the ability of decision-makers to respond effectively. Part I provides evidence to foster standardised performance information to support decision-making across health system levels. Part II describes three empirical studies, presenting the co-creation of practical tools to empower decision-makers across health system levels. These tools aim to strengthen both the operationalisation of resilience within care pathways and the integration of person-centredness as a fundamental dimension of performance.
The thesis seeks to support improvements in care experiences and outcomes for people living with cardiovascular diseases and cancer, whether in times of crises or within routine care delivery.