Journal of Gynecologic Oncology

Korean Society of Gynecologic Oncology (대한부인종양학회)
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Quality indicators for cervical cancer care in Japan

  • Watanabe, Tomone (Division of Health Services Research, Center for Cancer Control and Information Services, National Cancer Center) ;
  • Mikami, Mikio (Department of Obstetrics and Gynecology, Tokai University) ;
  • Katabuchi, Hidetaka (Department of Obstetrics and Gynecology, Faculty of Life Sciences, Kumamoto University) ;
  • Kato, Shingo (Department of Radiation Oncology, Saitama Medical University International Medical Center) ;
  • Kaneuchi, Masanori (Department of Obstetrics and Gynecology, Otaru General Hospital) ;
  • Takahashi, Masahiro (Department of Medical Oncology, Tohoku University Hospital) ;
  • Nakai, Hidekatsu (Department of Obstetrics and Gynecology, Kindai University Faculty of Medicine) ;
  • Nagase, Satoru (Department of Obstetrics and Gynecology, Yamagata University Faculty of Medicine) ;
  • Niikura, Hitoshi (Department of Obstetrics and Gynecology, Tohoku University) ;
  • Mandai, Masaki (Department of Gynecology and Obsteterics, Kyoto University Graduate School of Medicine) ;
  • Hirashima, Yasuyuki (Division of Gynecology, Shizuoka Cancer Center Hospital) ;
  • Yanai, Hiroyuki (Department of Pathology, Okayama University Hospital) ;
  • Yamagami, Wataru (Department of Obstetrics and Gynecology, Keio University School of Medicine) ;
  • Kamitani, Satoru (Division of Health Services Research, Center for Cancer Control and Information Services, National Cancer Center) ;
  • Higashi, Takahiro (Division of Health Services Research, Center for Cancer Control and Information Services, National Cancer Center)
  • Received : 2017.10.06
  • Accepted : 2018.07.09
  • Published : 2018.11.10
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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.

Keywords

Acknowledgement

Supported by : National Cancer Center, Japan

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