Is quality of colorectal cancer care good enough? Core measures development and its application for comparing hospitals in Taiwan

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• 作者：Kuo-Piao Chung (1) (2)
  Yun-Jau Chang (1) (3)
  Mei-Shu Lai (2) (4)
  Raymond Nien-Chen Kuo (1)
  Skye H Cheng (5)
  Li-Tzong Chen (6)
  Reiping Tang (7)
  Tsang-Wu Liu (8)
  Ming-Jium Shieh (9)
  
• 刊名：BMC Health Services Research
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：10
• 期：1
• 全文大小：818KB
• 参考文献：1. World Health Organizations: Global Burden of Disease Estimates. [http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf]
  2. Jemal A, Siegel R, Ward E, Hao YP, Xu JQ, Murray T, Thun MJ: Cancer statistics, 2008. / Ca-a Cancer Journal for Clinicians 2008, 58:71鈥?6. CrossRef
  3. Malin JL, Schneider EC, Epstein AM, Adams J, Emanuel EJ, Kahn KL: Results of the national initiative for cancer care quality: How can we improve the quality of cancer care in the United States? / J Clin Oncol 2006, 626鈥?34.
  4. Oliveria SA, Yood MU, Campbell UB, Yood SM, Stang P: Treatment and referral patterns for colorectal cancer. / Med Care 2004, 42:901鈥?06. CrossRef
  5. McGlynn EA, Asch SM, Adams J, Keesey J, Hicks J, DeCristofaro A, Kerr EA: The quality of health care delivered to adults in the United States. / N Engl J Med 2003, 348:2635鈥?645. CrossRef
  6. Schneider EC, Epstein AM, Malin JL, Kahn KL, Emanuel EJ: Developing a system to assess the quality of cancer care: ASCO's national initiative on cancer care quality. / J Clin Oncol 2004, 22:2985鈥?991. CrossRef
  7. Krzyzanowska MK, Weeks JC, Earle CC: Treatment of locally advanced pancreatic cancer in the real world: Population-based practices and effectiveness. / J Clin Oncol 2003, 21:3409鈥?414. CrossRef
  8. Jha AK, Li ZH, Orav EJ, Epstein AM: Care in US hospitals - the hospital quality alliance program. / N Engl J Med 2005, 353:265鈥?74. CrossRef
  9. National Cancer Policy Board: Health Care Delivery and Quality of Cancer Care. In / Ensuring Quality Cancer Care. Edited by: Hewitt M, Simone JV. Washington, IOM Books; 1999:116鈥?43.
  10. Epstein AM: Rolling down the runway - The challenges ahead for quality report cards. / JAMA 1998, 279:1691鈥?696. CrossRef
  11. Joint Commission on Accreditation of Healthcare Organizations (JACHO): Facts about ORYX for Hospitals (National Hospital Quality Measures). [http://www.jointcommission.org/AboutUs/Fact_Sheets/oryx_facts.htm]
  12. Leonardi MJ, McGory ML, Ko CY: Quality of care issues in colorectal cancer. / Clin Cancer Res 2007, 13:6897S-6900S. CrossRef
  13. Eddy DM: Performance measurement: problems and solutions. / Health Aff (Millwood) 1998, 17:7鈥?5. CrossRef
  14. Cheng TM: Taiwan's new national health insurance program: Genesis and experience so far. / Health Affairs 2003, 22:61鈥?6. CrossRef
  15. Chien CR, Tsai CM, Tang ST, Chung KP, Chiu CH, Lai MS: Quality of care for lung cancer in Taiwan: A pattern of care based on core measures in the Taiwan Cancer Database registry. / J Formos Med Assoc 2008, 107:635鈥?43. CrossRef
  16. Chung KP, Lai MS, Cheng SH, Tang ST, Huang CC, Cheng AL, Hsieh PC: Organization-based performance measures of cancer care quality: core measure development for breast cancer in Taiwan. / Eur J Cancer Care 2008, 17:5鈥?8.
  17. Bilimoria KY, Stewart AK, Winchester DP, Ko CY: The National Cancer Data Base: A powerful initiative to improve cancer care in the United States. / Ann Surg Oncol 2008, 15:683鈥?90. CrossRef
  18. Clinical Guidelines Committee, Royal College of Surgeons in Ireland (RCSI): / Colorectal Cancer Management Clinical Guidelines. 2002.
  19. Asch MS, Kerr AE, Hamilton GE Reifel, McGlynn LJ, A Elizabeth: / Quality of care for oncologic conditions and HIV: a review of the literature and quality indicators. RAND Books; 2000.
  20. Isler JT, Brown PC, Lewis FG, Billingham RP: The role of preoperative colonoscopy in colorectal cancer. / Dis Colon Rectum 1987, 30:435鈥?39. CrossRef
  21. Guidance on Cancer Services: / Improving outcomes in colorectal cancer: Updated Manual. NHS. 2003.
  22. Scottish Intercollegiate Guidelines Network (SIGN): / Management of colorectal cancer. A national clinical guideline. 2003.
  23. Nogueras JJ, Jagelman DG: Principles of surgical resection. Influence of surgical technique on treatment outcome. / Surg Clin North Am 1993, 73:103鈥?16.
  24. The Society of Surgery of the Alimentary Tract (SSAT): Surgical treatment of cancer of the colon or rectum. / J Gastrointest Surg 1999, 3:210鈥?11. CrossRef
  25. The American Joint Committee on Cancer: / AJCC Cancer Staging Manual, New York;. 6th edition. 2002.
  26. American College of Surgeons: / Cancer Program Standards 2004. Commission on Cancer; Chicago. 2004.
  27. Moertel CG: Chemotherapy for colorectal cancer. / N Engl J Med 1994, 330:1136鈥?142. CrossRef
  28. The Association of Coloproctology of Great Britation and Ireland: / Guidelines for the management of Colorectal Cancer. London;. 2001.
  29. Desch CE, Benson AB III, Smith TJ, Flynn PJ, Krause C, Loprinzi CL, Minsky BD, Petrelli NJ, Pfister DG, Somerfield MR: Recommended colorectal cancer surveillance guidelines by the American Society of Clinical Oncology. / J Clin Oncol 1999, 17:1312.
  30. Bond JH: Polyp guideline: diagnosis, treatment, and surveillance for patients with nonfamilial colorectal polyps. The Practice Parameters Committee of the American College of Gastroenterology. / Ann Intern Med 1993, 119:836鈥?43.
  31. Mandelblatt JS, Potosky AL: On the road to improving the quality of breast cancer care: A distance still to travel. / Med Care 2008, 46:759鈥?61. CrossRef
  32. Schneider EC, Riehl V, Courte-Wienecke S, Eddy DM, Sennett C: Enhancing performance measurement - NCQA's road map for a health information framework. / JAMA 1999, 282:1184鈥?190. CrossRef
  33. Reeves D, Campbell SM, Adams J, Shekelle PG, Kontopantelis E, Roland MO: Combining multiple indicators of clinical quality - An evaluation of different analytic approaches. / Med Care 2007, 45:489鈥?96. CrossRef
  34. Jencks SF, Huff ED, Cuerdon T: Change in the quality of care delivered to Medicare beneficiaries, 1998鈥?999 to 2000鈥?001. / JAMA 2003, 289:305鈥?12. CrossRef
  35. Wang JP, Kulaylat M, Rockette H, Hassett J, Rajput A, Bullai-Dunn K, Dayton M: Should total number of lymph nodes be used as a quality of care measure for stage III colon cancer? / Ann Surg 2009, 249:559鈥?63. CrossRef
  36. Bilimoria KY, Bentrem DJ, Stewart AK, Talamonti MS, Winchester DP, Russell TR, Ko CY: Lymph node evaluation as a colon cancer quality measure: A national hospital report card. / J Natl Cancer Inst 2008, 100:1310鈥?317. CrossRef
  37. Staiger DO, Dimick JB, Baser O, Fan Z, Birkmeyer JD: Empirically derived composite measures of surgical performance. / Med Care 2009, 47:226鈥?33. CrossRef
  38. Peters E, Dieckmann N, Dixon A, Hibbard JH, Mertz CK: Less is more in presenting quality information to consumers. / Med Care Res Rev 2007, 64:169鈥?90. CrossRef
  39. Jacobs R, Goddard M: How do performance indicators add up? An examination of composite indicators in public services. / Public Money & Management 2007, 27:103鈥?10. CrossRef
  40. Guthrie B: Measuring the quality of healthcare systems using composites. / Br Med J 2008, 337:a639. CrossRef
  41. Steel N, Bachmann M, Maisey S, Shekelle P, Breeze E, Marmot M, Melzer D: Self reported receipt of care consistent with 32 quality indicators: national population survey of adults aged 50 or more in England. / Br Med J 2008, 337:a957. CrossRef
  42. Institute of Medicine: Improving the 21st century health care system. In / Crossing the Quality Chasm: a New Health System for the 21st century. Washington, IOM Books; 2002:39鈥?0.
  43. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6963/10/27/prepub
  
• 作者单位：Kuo-Piao Chung (1) (2)
  Yun-Jau Chang (1) (3)
  Mei-Shu Lai (2) (4)
  Raymond Nien-Chen Kuo (1)
  Skye H Cheng (5)
  Li-Tzong Chen (6)
  Reiping Tang (7)
  Tsang-Wu Liu (8)
  Ming-Jium Shieh (9)
  
  1. Graduate Institute of Health Care Organization Administration, College of Public Health, National Taiwan University, Taipei, Taiwan
  2. Center for Health Insurance Research, College of Public Health, National Taiwan University, Taipei, Taiwan
  3. Department of General Surgery, Zhong-Siao Branch, Taipei City Hospital, Taipei, Taiwan
  4. Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
  5. Department of Radiation Oncology, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan
  6. Department of Internal Medicine, National Chung-Kung University Hospital, Tainan, Taiwan
  7. Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
  8. Division of Cancer Research, National Health Research Institutes, Taiwan
  9. Department of Gastroenterology, National Taiwan University Hospital, Taipei, Taiwan
  

文摘

Background Although performance measurement for assessing care quality is an emerging area, a system for measuring the quality of cancer care at the hospital level has not been well developed. The purpose of this study was to develop organization-based core measures for colorectal cancer patient care and apply these measures to compare hospital performance. Methods The development of core measures for colorectal cancer has undergone three stages including a modified Delphi method. The study sample originated from 2004 data in the Taiwan Cancer Database, a national cancer data registry. Eighteen hospitals and 5585 newly diagnosed colorectal cancer patients were enrolled in this study. We used indicator-based and case-based approaches to examine adherences simultaneously. Results The final core measure set included seventeen indicators (1 pre-treatment, 11 treatment-related and 5 monitoring-related). There were data available for ten indicators. Indicator-based adherence possesses more meaningful application than case-based adherence for hospital comparisons. Mean adherence was 85.8% (79.8% to 91%) for indicator-based and 82.8% (77.6% to 88.9%) for case-based approaches. Hospitals performed well (>90%) for five out of eleven indicators. Still, the performance across hospitals varied for many indicators. The best and poorest system performance was reflected in indicators T5-negative surgical margin (99.3%, 97.2% - 100.0%) and T7-lymph nodes harvest more than twelve(62.7%, 27.6% - 92.2%), both of which related to surgical specimens. Conclusions In this nationwide study, quality of colorectal cancer care still shows room for improvement. These preliminary results indicate that core measures for cancer can be developed systematically and applied for internal quality improvement.