Assessing the Quality of Cancer Care An Approach to Measurement in Georgia (2005) / Chapter Skim
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7 Crosscutting Issues in Assessing the Quality of Cancer Care
7 Crosscutting Issues in Assessing the Quality of Cancer Care
Pages 223-240
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From page 223... ...
Ganz, 2002 "Numerous scientific studies provide the evidence that certain U.S. popu lations experience significant disparities in risk, incidence, disease-stage diagnosis, care received, and disease outcomes for cancer." Making Cancer Health Disparities History Trans-HHS Cancer Health Disparities Progress Review Group (U.S.
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. There is an extensive literature validating numerous patient surveys, multi-symptom assessment tools, and quality-of-life instruments for cancer patients in clinical trials (Schag et al., 1991; Ware and Sherbourne, 1992; Cella et al., 1993, 1995; Esper et al., 1997; Brady et al., 1997; Cleary and Edgman-Levitan, 1997; Safran et al., 1998; McLachlan et al., 1998; Cleary, 1999; Ward et al., 1999)
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, for Research and patients in clinical trials includes: Treatment of Cancer including physical, -- QLQ-C30, core module; psychosocial, medical QLQ-BR23, breast cancer interactions, pain, sexual module and other side effects General health instruments Ambulatory Care Experiences The Health Institute, Patients' experiences with Survey (ACES) , includes: Tufts-New England their primary care physician, -- PCP-ACES, primary Medical Center specialist physicians, and care; SF-ACES, primary health plan care short form Consumer Assessment of Agency for Health Interpersonal aspects of Health Plan Survey (CAHPS)
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. More generic instruments, such as the Ambulatory Care Experiences Survey and the Primary Care Assessment Survey, collect data on patients' experiences with their physicians and health plan independent of diagnosis.
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of 1996. Under HIPAA regulations, central cancer registries are considered public health authorities with the legal authority "to collect or receive such information for the purposes of preventing or controlling disease, injury, vital events such as birth or death, and the conduct of public health surveillance, public health investigations, and public health interventions."2 Nevertheless, the committee urges GCC to explore the legal implications of using Georgia's central registries for quality-of-care research.
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Potential Topics for Cancer Patient Surveys The IOM committee recommends that GCC seek direct patient input on the quality of cancer care. By analyzing and reporting the findings from well-designed patient surveys and quality-of-life instruments, GCC can inform providers, policy makers, and consumers about how well cancer patients are being served across the continuum of care.
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Patients' health care experiences have been linked to clinically important, intermediate outcomes such as adherence to treatment regimens and following instructions after a hospital stay -- underscoring the significance of monitoring satisfaction and interpersonal experiences, such as patient preferences, patient-provider communication, adequate information for treatment decision making, knowledge of diagnostic and treatment expectations, and coordination of care (DiMatteo et al., 1993; Weinfurt, 2003; Schulman and Seils, 2003; Wickizer et al., 2004; DiMatteo, 2004)
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. African Americans, compared with all other racial or ethnic groups in the United States, have the highest mortality rate from all cancer sites combined and from breast, colorectal, lung, and prostate cancers individually (Table 7-3)
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bAll races. cInvasive female breast cancer only.
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. Two aspects of building a state data infrastructure for understanding and addressing health disparities require particular attention and action: (1)
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Kaiser Family Foundation, 2004. analyze socioeconomic factors through standardized geographical data.
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The North American Association of Central Cancer Registries BOX 7-2 Standardizing Racial and Ethnic Categories for Public Policy Uses Federal and some state data collection systems use standard categories of race and ethnicity to comply with the requirements of the federal Office of Manage ment and Budget (OMB)
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In social science research, socioeconomic status is commonly ascertained by developing indices combining measures of education, occupation, and income, but the routine collection of such information by cancer registries has not been possible because it usually cannot be found in medical records. Geocoding is the assignment of a code to a geographical location by matching an individual address to a census tract or other geographic unit, such as a county, public health district, or region.
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. SUMMARY In this chapter, the IOM committee has addressed two related crosscutting issues in assessing the quality of cancer care -- first, the use of cancer patient surveys, and second, the conduct of health disparities research.
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1993. The relation between health insurance coverage and clinical outcomes among women with breast cancer.
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1997. Measuring quality of life in men with prostate cancer using the functional assessment of cancer therapy-prostate instrument.
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as a measure of psychosocial function in breast cancer patients. Eur J Cancer.
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Report of the Trans-HHS Cancer Health Disparities Progress Review Group. Submitted to the Secretary, U.S.
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