The association between quality care and outcomes for a real-world population of Australian patients diagnosed with pancreatic cancer.

Autor:	Maharaj AD; School of Public Health and Preventative Medicine, Monash University, Victoria, Australia., Evans SM; School of Public Health and Preventative Medicine, Monash University, Victoria, Australia., Ioannou LJ; School of Public Health and Preventative Medicine, Monash University, Victoria, Australia., Croagh D; Monash Health, Victoria, Australia., Earnest A; School of Public Health and Preventative Medicine, Monash University, Victoria, Australia., Holland JF; School of Public Health and Preventative Medicine, Monash University, Victoria, Australia., Pilgrim CHC; Alfred Health, Victoria, Australia., Neale RE; QIMR Berghofer Medical Research Institute, Queensland, Australia., Goldstein D; Nelune Comprehensive Cancer Centre, New South Wales, Australia., Kench JG; Royal Prince Alfred Hospital, New South Wales, Australia., Merrett ND; School of Medicine, Western Sydney University, New South Wales, Australia., White K; Sydney Nursing School, University of Sydney, New South Wales, Australia., Burmeister EA; Queensland University, Brisbane, Australia., Evans PM; Peninsula Health, Victoria, Australia., Hayes TM; South West Health, Victoria, Australia., Houli N; Northern Health, Victoria, Australia., Knowles B; Royal Melbourne Hospital, Victoria, Australia., Leong T; Peter MacCallum Cancer Centre, Victoria, Australia., Nikfarjam M; Austin Health, Victoria, Australia., Philip J; St Vincent's Hospital Melbourne, Victoria, Australia., Quinn M; School of Public Health and Preventative Medicine, Monash University, Victoria, Australia., Shapiro J; Cabrini Health, Victoria, Australia., Smith MD; Cabrini Health, Victoria, Australia., Spillane JB; Peter MacCallum Cancer Centre, Victoria, Australia., Wong R; Eastern Health Clinical School, Monash University, Victoria, Australia., Zalcberg JR; School of Public Health and Preventative Medicine, Monash University, Victoria, Australia; Alfred Health, Victoria, Australia. Electronic address: john.zalcberg@monash.edu.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2022 Jun; Vol. 24 (6), pp. 950-962. Date of Electronic Publication: 2021 Nov 16.
DOI:	10.1016/j.hpb.2021.11.005
Abstrakt:	Background: This study: (i) assessed compliance with a consensus set of quality indicators (QIs) in pancreatic cancer (PC); and (ii) evaluated the association between compliance with these QIs and survival. Methods: Four years of data were collected for patients diagnosed with PC. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). A multivariable analysis tested the relationship between significant patient and hospital characteristics, patient cluster effects within hospitals and survival. Results: 1061 patients were eligible for this study. Significant association with improved survival were: (i) in the potentially resectable group having adjuvant chemotherapy administered following surgery or a reason documented (HR, 0.29; 95 CI, 0.19-0.46); (ii) in the locally advanced group included having chemotherapy ± chemoradiation, or a reason documented for not undergoing treatment (HR, 0.38; 95 CI, 0.25-0.58); and (iii) in the metastatic disease group included having documented performance status at presentation (HR, 0.65; 95 CI, 0.47-0.89), being seen by an oncologist in the absence of treatment (HR, 0.48; 95 CI, 0.31-0.77), and disease management discussed at a multidisciplinary team meeting (HR, 0.79; 95 CI, 0.64-0.96). Conclusion: Capture of a concise data set has enabled quality of care to be assessed. (Copyright © 2021 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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