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KMID : 1137020180290060083
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Journal of Gynecologic Oncology
2018 Volume.29 No. 6 p.83 ~ p.83
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Quality indicators for cervical cancer care in Japan
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Watanabe Tomone
Mikami Mikio
Katabuchi Hidetaka
Kato Shingo
Kaneuchi Masanori
Takahashi Masahiro
Nakai Hidekatsu
Nagase Satoru
Niikura Hitoshi
Mandai Masaki
Hirashima Yasuyuki
Yanai Hiroyuki
Yamagami Wataru
Kamitani Satoru
Higashi Takahiro
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Abstract
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Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan.
Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected.
Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for ‘cystoscope or proctoscope for stage IVA’ to 98.8% for ‘chemotherapy using platinum for stage IVB’. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively.
Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.
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KEYWORD
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Quality Indicators, Uterine Cervical Neoplasms, Standard of Care, Guideline Adherence, Practice Guideline
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