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利用登记数据和电子健康记录评估癌症护理质量的可行性:一项基于人群的研究。

Feasibility of evaluating quality cancer care using registry data and electronic health records: a population-based study.

机构信息

Epidemiologia Clinica e Descrittiva, ISPO, Firenze, Italia.

出版信息

Int J Qual Health Care. 2012 Aug;24(4):411-8. doi: 10.1093/intqhc/mzs020. Epub 2012 May 16.

DOI:10.1093/intqhc/mzs020
PMID:22597705
Abstract

OBJECTIVE

To evaluate the quality of patients care, a set of indicators of the standards of cancer care were defined.

PARTICIPANTS

We developed a set of indicators to assess the implementation in daily practice of recommendation produced by a regional network (Istituto Toscano Tumori). This set was tested in a retrospective study in the resident population of the Tuscany Region; the regional health system is organized on 12 local health authorities which refer to three macro areas (Area Vasta). The study included incident colorectal, lung and breast cancer cases listed in 2004 for the Tuscan Cancer Registry, a population-based registry which collected tumor cases diagnosed in all residents in Tuscany. Electronic data from registry database were used to determine the compliance with each indicator for patients in 2004. To validate the results, an ad hoc clinical survey including the same geographical area for the year 2006 was performed.

INTERVENTION

None.

MAIN OUTCOME MEASURES

The proportion of patients who fulfilled each of the indicators.

RESULTS

Our study showed the feasibility of the evaluation of the quality of cancer care using cancer registry population-based data and major computerized information systems. The estimation of the selected indicators confirmed a good homogeneity among areas, and globally revealed a good intraregional performance.

CONCLUSIONS

Further work is needed to develop specific quality measures, particularly about structural data and to continually revise indicators of quality of care. Data from a cancer registry, however, can be useful to evaluate quality of cancer care.

摘要

目的

为了评估患者护理质量,制定了一套癌症护理标准指标。

参与者

我们开发了一套指标,以评估区域网络(托斯卡纳肿瘤研究所)提出的建议在日常实践中的实施情况。该套指标在托斯卡纳地区居民的回顾性研究中进行了测试;该地区的卫生系统由 12 个地方卫生当局组织,这些当局隶属于三个大区(瓦斯塔大区)。该研究包括 2004 年托斯卡纳癌症登记处登记的结直肠癌、肺癌和乳腺癌的发病病例,该登记处是一个基于人群的登记处,收集了所有居住在托斯卡纳的肿瘤病例。使用登记数据库的电子数据来确定 2004 年每位患者对每个指标的遵守情况。为了验证结果,在 2006 年对同一地理区域进行了专门的临床调查。

干预措施

无。

主要观察指标

符合每个指标的患者比例。

结果

我们的研究表明,使用癌症登记处基于人群的数据和主要计算机化信息系统评估癌症护理质量是可行的。所选指标的估计显示了区域之间的良好同质性,总体上显示了良好的区域内表现。

结论

需要进一步制定具体的质量措施,特别是关于结构数据的措施,并不断修订护理质量指标。然而,癌症登记处的数据可用于评估癌症护理质量。

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