Aims
To develop a Cancer Quality Index from routine data that tracks Queensland’s progress in improving cancer care and shows where quality and performance improvements are needed.
Methods
The Queensland Oncology Repository (QOR) compiles and collates administrative and clinical data including the Queensland Cancer Registry, hospital admissions, deaths, treatments, public and private pathology. QOR contains approximately 350,000 matched and linked records of cancer patients from 2000-2010. Using a clinical peer review process QOR data was used to develop a Queensland Cancer Quality Index (QCQI) for Cancer Surgery which reports on complex and high volume cancers.
Results
The QCQI for Cancer Surgery reports on 12 process and outcome indicators across six quality dimensions: effective, efficient, accessible, safe, equitable and integrated for breast, colon, lung, oesophago-gastric, pancreatic and hepato-biliary and rectal cancers. Indicators are reported for two time periods (2001-2005, 2006-2010) and 2011 and public and private, indigenous and non-indigenous, rural, regional and metropolitan, >65 years and socially disadvantaged populations. Examples of indicators reported in the QCQI include: length of stay in public and private hospitals for major resections for colon cancer (11 days and 9 days); % rural, regional and metropolitan women that wait > 30 days from diagnosis to first breast cancer surgery (32%, 31% and 21%); 30 day post-operative mortality for non-small cell lung cancer patients receiving lung resection in 2001-2005 and 2006-2010 and 2011 (2.5%, 1.2% and 1.1%).
Conclusions
The QCQI is a tool, developed from routine data, for tracking the quality of cancer care in Queensland. The QCQI is a public report which will be published annually and disseminated to Hospital and Health Services. The QCQI highlights areas for improvement and identifies the areas of cancer care performing well. The QCQI is currently being expanded to incorporate quality indicators for radiotherapy and systemic therapy.