RPCI Clinician Reports Quality Measures Can Improve Cancer Care

 

Researchers tested a case management system linking claims data to mammogram information to help physicians assure appropriate follow-up care for women with abnormal mammograms. Previous studies show up to 20% of women do not get recommended follow-up care. This study analyzed electronic medical records from a single payer and a single practice which performs about 8,000 mammograms annually with approximately 500 of those exhibiting abnormalities. Physicians were notified of each abnormal mammogram and provided with a standardized care pathway for management. In this study, all patients except one patient (who refused biopsy) received treatment within a time frame during which appropriate care can be delivered. This study demonstrates that a practice-based intervention has the potential to improve the management of other cancers and chronic diseases.

 

 

The National Quality Forum (NQF) recently approved quality measures for cancer care. This study tested the ability to match claims data from the National Cancer Data Base (NCDB) to NQF breast cancer measures from one regional payer in Western New York (WNY) supported through registry data from three WNY hospitals from 2001 to 2003. Claims data from 480 women who were treated with surgery for breast cancer for adjuvant therapy including hormone therapy, radiation therapy with breast conserving surgery and chemotherapy were analyzed to determine if quality measures can be applied using claims information. The claims data provided information not collected by the registry including specific drugs used and duration of treatment and therefore may be a robust tool to apply quality measures for cancer care.

 

 

The National Quality Forum (NQF) recently endorsed the first nationally recognized hospital-based measures for quality of care for breast cancer. There is substantial evidence that practice guidelines may be effective in influencing provider behavior and patient outcomes. This study evaluated the use of RT with breast conserving therapy for women under age 70 in 2003-2004, and found extensive variation in treatment delivery and the need for improvement to meet this nationally recognized standard of care.

Data analyzed from 1,303 hospitals reporting to the National Cancer Data Base on women under age 70 treated with breast conserving therapy found that 74.5% received radiation therapy within one year, and 54% received RT within six months of diagnosis. However, RT was less likely to be received by African American and Hispanic women versus Caucasian women, those with less versus more education, women with no insurance or Medicaid versus managed care, and those women treated at hospitals that performed lower versus higher case volumes. While RT is a key quality measure to improve care, this study indicates there is a wide variation among the delivery of RT to women treated for breast cancer.

The American Society of Clinical Oncology (ASCO) is a non-profit organization, founded in 1964, with overarching goals of improving cancer care and prevention and ensuring that all patients with cancer receive care of the highest quality. Nearly 25,000 oncology practitioners belong to ASCO, representing all oncology disciplines (medical, radiologic and surgical oncology) and subspecialties. Members include physicians and health-care professionals participating in approved oncology training programs, oncology nurses and other practitioners with a predominant interest in oncology. 

Roswell Park Cancer Institute, founded in 1898, is the nation’s first cancer research, treatment and education center and is the only National Cancer Institute-designated comprehensive cancer center in Upstate New York. RPCI is a member of the prestigious National Comprehensive Cancer Network, an alliance of the nation’s leading cancer centers. Roswell Park has affiliate sites and collaborative programs in New York, Pennsylvania, and in China. For more information, visit RPCI’s website at www.roswellpark.org, call 1-877-ASK-RPCI (1-877-275-7724) or e-mail askrpci@roswellpark.org.

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