Developing and measuring a set of process and outcome indicators for breast cancer

Stordeur, Sabine; Vrijens, France; Devriese, Stephan; Beirens, Koen; Van Eycken, Elizabeth; Vlayen, Joan

doi:10.1016/j.breast.2011.10.003

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Developing and measuring a set of process and outcome indicators for breast cancer

Sabine Stordeur
- Belgian Health Care Knowledge Centre, Boulevard du Botanique 55, B-1000 Brussels, Belgium
- Corresponding author. Tel.: +32 2 287 33 13; fax: +32 2 287 33 85.
France Vrijens
- Belgian Health Care Knowledge Centre, Boulevard du Botanique 55, B-1000 Brussels, Belgium
- Tel.: +32 2 287 33 88; fax: +32 2 287 33 85.
Stephan Devriese
- Belgian Health Care Knowledge Centre, Boulevard du Botanique 55, B-1000 Brussels, Belgium
- Tel.: +32 2 287 33 88; fax: +32 2 287 33 85.
Koen Beirens
- Belgian Cancer Register, Koningsstraat 215, B-1210 Brussels, Belgium
- Tel.: +32 2 250 10 13; fax: +32 2 250 10 11.
Elizabeth Van Eycken
- Belgian Cancer Register, Koningsstraat 215, B-1210 Brussels, Belgium
- Tel.: +32 2 250 10 13; fax: +32 2 250 10 11.
Joan Vlayen
- Belgian Health Care Knowledge Centre, Boulevard du Botanique 55, B-1000 Brussels, Belgium
- Tel.: +32 2 287 33 88; fax: +32 2 287 33 85.

Received 26 July 2011; received in revised form 5 October 2011; accepted 12 October 2011. published online 07 November 2011.
Corrected Proof

Abstract

Purpose

This study aimed at developing and measuring a set of indicators to monitor the quality of breast cancer care, to make comparisons over time and to support quality improvement for all practitioners and centres involved in the care of breast cancer women.

Methods

Quality indicators were identified from a systematic literature search and the 2010 Belgian evidence-based clinical practice guideline. The selection process involved an expert panel evaluating reliability, relevance, interpretability and actionability of each indicator. The quality indicators were tested using the Belgian Cancer Registry data linked with claims data for all women registered with breast cancer in Belgium between 2001 and 2006 (n = 50,039).

Results

The selection process led to a final set of 32 indicators. Of these, 12 were measurable using the available data, while 1 indicator was measurable using proxy information. Five-year relative survival was 98%, 87%, 68% and 29% for pStage I, II, III and cStage IV respectively. Overall 5-year survival slightly improved for pStage II, III and cStage IV between 2001 and 2004. Of the surgically treated women, 60% underwent breast conserving surgery, 85% received adjuvant systemic treatment and 86% were irradiated postoperatively. In 80% of women treated for breast cancer, at least one mammography was performed within one year after the last treatment.

Conclusion

The present study demonstrates the feasibility to develop a multidisciplinary set of quality indicators for breast cancer. Using national cancer registry data linked to claims data, 13 indicators were measurable, showing results that largely correspond to other studies in the field.

Keywords: Quality indicators, health care, Breast Neoplasms, Registries, Quality of Health Care, Survival analysis