학술논문
Development and implementation of a population-based breast cancer quality index in Queensland, Australia.
Document Type
Academic Journal
Author
Philpot S; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Burke St, Woolloongabba, Qld, 4102, Australia. Electronic address: Shoni.Philpot@health.qld.gov.au.; Youl PH; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Burke St, Woolloongabba, Qld, 4102, Australia.; Harden H; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Burke St, Woolloongabba, Qld, 4102, Australia.; Morris M; Sunshine Coast Hospital and Health Service, Sunshine Coast University Hospital, 6 Doherty Street, Birtinya, Qld, 4575, Australia.; Furnival C; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Burke St, Woolloongabba, Qld, 4102, Australia.; Dunn N; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Burke St, Woolloongabba, Qld, 4102, Australia.; Moore J; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Burke St, Woolloongabba, Qld, 4102, Australia.; Theile DE; Cancer Alliance Queensland, Metro South Hospital and Health Service, Princess Alexandra Hospital, Burke St, Woolloongabba, Qld, 4102, Australia; Translational Research Institute, University of Queensland, Brisbane, Australia.
Source
Publisher: Elsevier Ltd Country of Publication: England NLM ID: 101639933 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-5383 (Electronic) Linking ISSN: 22135383 NLM ISO Abbreviation: J Cancer Policy Subsets: MEDLINE
Subject
Language
English
Abstract
Background: While quality indicators (QI) are relatively commonplace, QIs focusing on breast cancer treatment and outcomes have not been previously developed in Australia. We describe the development and implementation of the Queensland Breast Cancer Quality Index (BCQI) and report on trends in performance indicators over time.
Methods: Development of the BCQI was overseen by a clinician-led quality assurance committee covering several clinical disciplines. Using a population-based dataset of female patients diagnosed with breast cancer from 2007 to 2016 (n = 27,541) we examined trends in indicators over time.
Results: The BCQI includes two quality dimensions (Effective and Accessible) and 14 indicators for public and private cancer services. Rates of re-excision following breast conservation surgery (BCS) and conversion of BCS to mastectomy reduced over time (p < 0.001 and p = 0.005, respectively). BCS was less common for women living outside a major city (p < 0.001), who had their surgery in a public (p < 0.001) or low volume hospital (p < 0.001).
Conclusions: Application of the BCQI at a population-level demonstrated our results are comparable to, and in some cases superior to other jurisdictions. We identified some areas where improvement over time has occurred, while also identifying some outcomes requiring further investigation.
Policy Summary: The BCQI is a well-established and valuable tool for measuring and monitoring breast cancer care. Practice indicators provide useful information to assist with identifying services performing well as well as those that may benefit from improvement.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Methods: Development of the BCQI was overseen by a clinician-led quality assurance committee covering several clinical disciplines. Using a population-based dataset of female patients diagnosed with breast cancer from 2007 to 2016 (n = 27,541) we examined trends in indicators over time.
Results: The BCQI includes two quality dimensions (Effective and Accessible) and 14 indicators for public and private cancer services. Rates of re-excision following breast conservation surgery (BCS) and conversion of BCS to mastectomy reduced over time (p < 0.001 and p = 0.005, respectively). BCS was less common for women living outside a major city (p < 0.001), who had their surgery in a public (p < 0.001) or low volume hospital (p < 0.001).
Conclusions: Application of the BCQI at a population-level demonstrated our results are comparable to, and in some cases superior to other jurisdictions. We identified some areas where improvement over time has occurred, while also identifying some outcomes requiring further investigation.
Policy Summary: The BCQI is a well-established and valuable tool for measuring and monitoring breast cancer care. Practice indicators provide useful information to assist with identifying services performing well as well as those that may benefit from improvement.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)