Hematopoietic stem cell transplantation in Switzerland: a comprehensive quality control report on centre effect
| Autor: | Passweg, J, Baldomero, H, Stern, M, Bargetzi, M, Ghielmini, M, Leibundgut, K, Duchosal, M, Hess, U, Seger, R, Buhrfeind, E, Schanz, U, Gratwohl, A |
|---|---|
| Přispěvatelé: | University of Zurich, Passweg, J, Swiss Blood and Marrow Stem Cells Transplant Group (SBST) |
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male Databases Factual Quality Assurance Health Care Adolescent 610 Medicine & health Quality Assurance Health Care/*statistics & numerical data 2700 General Medicine Young Adult Aged Child Child Preschool Databases Factual/statistics & numerical data Female Hematopoietic Stem Cell Transplantation/mortality Hematopoietic Stem Cell Transplantation/statistics & numerical data Humans Infant Middle Aged Quality Assurance Health Care/statistics & numerical data Registries/statistics & numerical data Retrospective Studies Risk Factors Survival Analysis Switzerland Treatment Outcome Registries ddc:616 Hematopoietic Stem Cell Transplantation 10036 Medical Clinic 10032 Clinic for Oncology and Hematology Hematopoietic Stem Cell Transplantation/*mortality/*statistics & numerical data |
| Zdroj: | Schweizerische medizinische Wochenschrift, Vol. 140, No 23-24 (2010) pp. 326-334 Swiss medical weekly, vol. 140, no. 23-24, pp. 326-334 |
| ISSN: | 0036-7672 |
| Popis: | QUESTIONS UNDER STUDY / PRINCIPLES: Interest groups advocate centre-specific outcome data as a useful tool for patients in choosing a hospital for their treatment and for decision-making by politicians and the insurance industry. Haematopoietic stem cell transplantation (HSCT) requires significant infrastructure and represents a cost-intensive procedure. It therefore qualifies as a prime target for such a policy. METHODS: We made use of the comprehensive database of the Swiss Blood Stem Cells Transplant Group (SBST) to evaluate potential use of mortality rates. Nine institutions reported a total of 4717 HSCT - 1427 allogeneic (30.3%), 3290 autologous (69.7%) - in 3808 patients between the years 1997 and 2008. Data were analysed for survival- and transplantation-related mortality (TRM) at day 100 and at 5 years. RESULTS: The data showed marked and significant differences between centres in unadjusted analyses. These differences were absent or marginal when the results were adjusted for disease, year of transplant and the EBMT risk score (a score incorporating patient age, disease stage, time interval between diagnosis and transplantation, and, for allogeneic transplants, donor type and donor-recipient gender combination) in a multivariable analysis. CONCLUSIONS: These data indicate comparable quality among centres in Switzerland. They show that comparison of crude centre-specific outcome data without adjustment for the patient mix may be misleading. Mandatory data collection and systematic review of all cases within a comprehensive quality management system might, in contrast, serve as a model to ascertain the quality of other cost-intensive therapies in Switzerland. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|