Quality indicators for cervical cancer care in Japan.
- Author:
Tomone WATANABE
1
;
Mikio MIKAMI
;
Hidetaka KATABUCHI
;
Shingo KATO
;
Masanori KANEUCHI
;
Masahiro TAKAHASHI
;
Hidekatsu NAKAI
;
Satoru NAGASE
;
Hitoshi NIIKURA
;
Masaki MANDAI
;
Yasuyuki HIRASHIMA
;
Hiroyuki YANAI
;
Wataru YAMAGAMI
;
Satoru KAMITANI
;
Takahiro HIGASHI
Author Information
- Publication Type:Practice Guideline ; Original Article
- Keywords: Quality Indicators; Uterine Cervical Neoplasms; Standard of Care; Guideline Adherence; Practice Guideline
- MeSH: Guideline Adherence; Humans; Insurance; Japan*; Methods; Patient Care; Platinum; Proctoscopes; Qi; Standard of Care; Uterine Cervical Neoplasms*
- From:Journal of Gynecologic Oncology 2018;29(6):e83-
- CountryRepublic of Korea
- Language:English
- 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.
