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Title
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Quality of care and variability in lung cancer management across Belgian hospitals : a population-based study using routinely available data
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Author
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Abstract
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| 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. |
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Language
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English
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Source (journal)
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International journal for quality in health care. - Oxford
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Publication
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Oxford
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2018
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ISSN
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1353-4505
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DOI
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10.1093/INTQHC/MZY027
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Volume/pages
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30
:4
(2018)
, p. 306-312
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ISI
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000432295500011
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Pubmed ID
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29506181
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Full text (Publisher's DOI)
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Full text (open access)
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