Quality of care and variability in lung cancer management across Belgian hospitals : a population-based study using routinely available data
Autor: | France Vrijens, Cindy De Gendt, Leen Verleye, Jo Robays, Viki Schillemans, Cécile Camberlin, Sabine Stordeur, Cécile Dubois, Elisabeth Van Eycken, Isabelle Wauters, Jan P Van Meerbeeck |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Male
medicine.medical_specialty Funnel plot Lung Neoplasms Population MEDLINE Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Belgium Multidisciplinary approach Positron Emission Tomography Computed Tomography medicine Humans Registries 030212 general & internal medicine Stage (cooking) Lung cancer education Aged Neoplasm Staging Quality Indicators Health Care Retrospective Studies Aged 80 and over education.field_of_study business.industry Health Policy Public Health Environmental and Occupational Health Brain Retrospective cohort study General Medicine Middle Aged medicine.disease Hospitals Cancer registry 030220 oncology & carcinogenesis Emergency medicine Female Human medicine business |
Zdroj: | International journal for quality in health care |
ISSN: | 1353-4505 |
Popis: | 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. 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. Intervention: None. 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. 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. 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. |
Databáze: | OpenAIRE |
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