Assessing the Quality of Cancer Care An Approach to Measurement in Georgia (2005) / Chapter Skim
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Executive Summary
Executive Summary
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. The measure set should be pertinent to the mission and goals of GCC, in a form that is reasonable to implement, and drawn from established clinical guidelines or quality measures already in use.
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In addition, the committee recommended that Georgia take steps to capture cancer patients' experiences as indicators of quality, as well as to understand and seek to reduce economic, geographic, and racial or ethnic disparities in the cancer burden and quality of cancer care. The committee believes that evaluating patients' experiences will be as critical to assessing the quality of cancer care as deploying the 52 recommended quality indicators.
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, the committee also took the view that measuring patients' perspectives, experiences, and preferences regarding the structure, process, and outcomes of cancer care is fundamental to measuring quality. Using the excellent work of Donabedian and the IOM Roundtable on Health Care Quality as background, the committee devised a scoring evaluation and an informative staff-prepared one-page description for the review of potential quality measures as noted below.
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. The committee recommends that Georgia adopt 10 quality measures related to cancer prevention: two measures of smoking rates, two measures of the delivery of smoking cessation interventions, one measure of obesity trends, and five measures of cancer incidence rates.
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Adequacy of pathology reports on lung cancer surgical specimens 5-10. Adequacy of pathology reports on prostate cancer surgical specimens Documentation of cancer pathologic stage before chemotherapy or radiation treatment begins 5-11.
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Prostate cancer mortality rate 6-23. All cancers mortality rate aNOTE: The IOM committee's recommended quality-of-cancer-care measures for Georgia pertain primarily to the control of four major cancers: breast, colorectal, lung, and prostate cancer.
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and the incidence of breast, colorectal, lung, and prostate cancer, respectively. Quality Measures Related to Detecting Cancer Early (Ch.
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Two of the recommended quality measures related to early detection track breast cancer stage at diagnosis. One is the proportion of new breast cancer cases in Georgia diagnosed at a treatable early stage (in situ or localized)
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Pathologists' findings are critical to proper cancer staging, treatment decisions, and the evaluation of a patient's prognosis. Thus, five of the recommended quality measures related to cancer diagnosis pertain to the adequacy of pathology reports on surgical specimens from patients with breast, colorectal, lung, or prostate cancer.
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. The other three recommended quality measures related to primary therapy for cancer track whether prostate cancer patients receive evidencebased care.
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The fourth recommended quality measure related to adjuvant therapy is the proportion of selected colon cancer patients who receive adjuvant chemotherapy after surgery. Numerous randomized trials have shown that adjuvant chemotherapy substantially increases disease-free and overall survival of patients with Stage III colon cancer (Moertel et al., 1995; IMPACT Investigators, 1995; Wolmark et al., 1999; Potosky et al., 2002)
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For that reason, the committee recommends that Georgia track 5- and 10-year relative cancer survival rates for each of the state's four most common cancers: breast, colorectal, lung, and prostate cancer. The committee also recommends that Georgia track mortality rates caused by each of these four cancers, along with the mortality rate for all types of cancer.
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a patient survey program to collect data pertaining to cancer patients' experiences that can be used to assess the quality of cancer care, and (2) a system for the collection and analysis of high-quality data that yield insights into how best to address racial, ethnic, and socioeconomic disparities in the cancer burden and quality of cancer care.
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1998. Cancer care during the last phase of life.
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1999a. Ensuring Quality Cancer Care.
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2002. Selecting National Goals and Core Measures of Cancer Care Quality (Background Paper #2)
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2003. Standardizing Quality Measures for Cancer Care Summary Report.
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