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. 2013 May 1;8(5):e60947.
doi: 10.1371/journal.pone.0060947. Print 2013.

Evaluating the quality of colorectal cancer care across the interface of healthcare sectors

Sabine Ludt  1 , Elisabeth Urban, Jörg Eckardt, Stefanie Wache, Björn Broge, Petra Kaufmann-Kolle, Günther Heller, Antje Miksch, Katharina Glassen, Katja Hermann, Regine Bölter, Dominik Ose, Stephen M Campbell, Michel Wensing, Joachim Szecsenyi
Affiliations

Evaluating the quality of colorectal cancer care across the interface of healthcare sectors

Sabine Ludt et al. PLoS One. .

Abstract

Background: Colorectal cancer (CRC) has a high prevalence in western countries. Diagnosis and treatment of CRC is complex and requires multidisciplinary collaboration across the interface of health care sectors. In Germany, a new nationwide established program aims to provide quality information of healthcare delivery across different sectors. Within this context, this study describes the development of a set of quality indicators charting the whole pathway of CRC-care including data specifications that are necessary to operationalize these indicators before practice testing.

Methods: Indicators were developed following a systematic 10 step modified 'RAND/UCLA Appropriateness Method' which involved a multidisciplinary panel of thirteen participants. For each indicator in the final set, data specifications relating to sources of quality information, data collection procedures, analysis and feedback were described.

Results: The final indicator set included 52 indicators covering diagnostic procedures (11 indicators), therapeutic management (28 indicators) and follow-up (6 indicators). In addition, 7 indicators represented patient perspectives. Primary surgical tumor resection and pre-operative radiation (rectum carcinoma only) were perceived as most useful tracer procedures initiating quality data collection. To assess the quality of CRC care across sectors, various data sources were identified: medical records, administrative inpatient and outpatient data, sickness-funds billing code systems and patient survey.

Conclusion: In Germany, a set of 52 quality indicators, covering necessary aspects across the interfaces and pathways relevant to CRC-care has been developed. Combining different sectors and sources of health care in quality assessment is an innovative and challenging approach but reflects better the reality of the patient pathway and experience of CRC-care.

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Conflict of interest statement

Competing Interests: JS is a director and shareholder of the AQUA-institute which is responsible for the development of the SQG program by contract with the Federal Joint Committee. SL, EU, AM, KG, KH, RB, and DO are employees of the department of General Practice and Health Services Research at the University Hospital of Heidelberg. The department is a contract partner of the AQUA-Institute. SMC is an expert in the field of indicator development and has a contract with the department of General Practice and Health Services Research. BB, JE, SW, PK-K and GH are employees and MW's institute has a contract with the AQUAinstitute. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Systematic literature search - Flow chart.
Figure 2
Figure 2. No of quality indicators identified by systematic search (allocated to the OECD quality model dimensions) .
See this image and copyright information in PMC

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