J Gynecol Oncol.  2018 Nov;29(6):e83. 10.3802/jgo.2018.29.e83.

Quality indicators for cervical cancer care in Japan

• Watanabe T
• Mikami M
• Katabuchi
• Kato S
• Kaneuchi M
• Takahashi
• Nakai H
• Nagase S
• Niikura H
• Mandai M
• Hirashima
• Yanai H
• Yamagami W
• Kamitani S
• Higashi T

• KMID: 2431230
• DOI: http://doi.org/10.3802/jgo.2018.29.e83

Abstract

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.

Keyword

Quality Indicators; Uterine Cervical Neoplasms; Standard of Care; Guideline Adherence; Practice Guideline

MeSH Terms

Guideline Adherence
Humans
Insurance
Japan*
Methods
Patient Care
Platinum
Proctoscopes
Qi
Standard of Care
Uterine Cervical Neoplasms*
Platinum

Reference

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