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Quality of care and variability in lung cancer management across Belgian hospitals: a population-based study using routinely available data.
- Source :
-
International journal for quality in health care : journal of the International Society for Quality in Health Care [Int J Qual Health Care] 2018 May 01; Vol. 30 (4), pp. 306-312. - Publication Year :
- 2018
-
Abstract
- Objective: To evaluate the quality of care for all patients diagnosed with lung cancer in Belgium based on a set of evidence-based quality indicators and to study the variability of care between hospitals.<br />Design, Setting, Participants: A retrospective study based on linked data from the cancer registry, insurance claims and vital status for all patients diagnosed with lung cancer between 2010 and 2011. Evidence-based quality indicators were identified from a systematic literature search. A specific algorithm to attribute patients to a centre was developed, and funnel plots were used to assess variability of care between centres.<br />Intervention: None.<br />Main Outcome Measure: The proportion of patients who received appropriate care as defined by the indicator. Secondary outcome included the variability of care between centres.<br />Results: Twenty indicators were measured for a total of 12 839 patients. Good results were achieved for 60-day post-surgical mortality (3.9%), histopathological confirmation of diagnosis (93%) and for the use of PET-CT before treatment with curative intent (94%). Areas to be improved include the reporting of staging information to the Belgian Cancer Registry (80%), the use of brain imaging for clinical stage III patients eligible for curative treatment (79%), and the time between diagnosis and start of first active treatment (median 20 days). High variability between centres was observed for several indicators. Twenty-three indicators were found relevant but could not be measured.<br />Conclusion: This study highlights the feasibility to develop a multidisciplinary set of quality indicators using population-based data. The main advantage of this approach is that not additional registration is required, but the non-measurability of many relevant indicators is a hamper. It allows however to easily point to areas of large variability in care.
- Subjects :
- Aged
Aged, 80 and over
Belgium
Brain diagnostic imaging
Female
Hospitals statistics & numerical data
Humans
Lung Neoplasms diagnostic imaging
Lung Neoplasms mortality
Male
Middle Aged
Neoplasm Staging
Positron Emission Tomography Computed Tomography statistics & numerical data
Registries
Retrospective Studies
Time-to-Treatment statistics & numerical data
Lung Neoplasms diagnosis
Lung Neoplasms surgery
Quality Indicators, Health Care statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1464-3677
- Volume :
- 30
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- International journal for quality in health care : journal of the International Society for Quality in Health Care
- Publication Type :
- Academic Journal
- Accession number :
- 29506181
- Full Text :
- https://doi.org/10.1093/intqhc/mzy027