Pediatric Oncology Group of Ontario (POGO), Toronto, ON, Canada.
Value Health. 2013 Jun;16(4):647-54. doi: 10.1016/j.jval.2013.03.1627.
A set of indicators to assess the quality of a childhood cancer system has not been identified in any jurisdiction internationally, despite the movement toward increased accountability and provision of high-quality care with limited health care resources. This study was conducted to develop a set of quality indicators (QIs) of a childhood cancer control and health care delivery system in Ontario, Canada.
A systematic review and targeted gray literature search were conducted to identify potential childhood cancer QIs. A series of investigator focus group sessions followed to review all QIs identified in the literature, and to generate a provisional QI set for a childhood cancer system. QIs were evaluated by three content experts in a sequential selection process on the basis of a series of criteria to select a subset for presentation to stakeholders. Following an appraisal of the relevance of quality assessment frameworks, remaining QIs were mapped onto the Cancer System Quality Index framework.
The systematic review yielded few relevant childhood cancer system QIs. Overall, 120 provisional QIs were developed by the investigator group. Based on median QI rating scores, representation across the childhood cancer continuum, and feasibility of data collection, a subset of 33 QIs was selected for stakeholder consideration.
The subset of 33 QIs developed on the basis of a systematic literature review and consensus provides the basis for the selection of a set of QIs for ongoing, standardized monitoring of various dimensions of quality in a childhood cancer system.
尽管在有限的医疗资源下，提高医疗责任制和提供高质量的医疗服务已成为一种趋势，但在国际上任何司法管辖区都尚未确定一套用于评估儿童癌症系统质量的指标。本研究旨在制定加拿大安大略省儿童癌症控制和医疗服务提供系统的一套质量指标 (QIs)。
进行了系统评价和有针对性的灰色文献搜索，以确定潜在的儿童癌症 QIs。随后进行了一系列调查员焦点小组会议，以审查文献中确定的所有 QIs，并为儿童癌症系统生成一个暂定的 QI 集。质量专家根据一系列标准，在顺序选择过程中对 QIs 进行评估，以选择一组提交给利益相关者。在评估质量评估框架的相关性之后，剩余的 QIs 被映射到癌症系统质量指数框架上。
系统评价仅产生了一些相关的儿童癌症系统 QIs。总体而言，调查员小组制定了 120 个暂定 QIs。基于中位数 QI 评分、儿童癌症连续体的代表性以及数据收集的可行性，选择了 33 个 QIs 作为利益相关者考虑的子集。
基于系统文献综述和共识制定的 33 个 QIs 子集为选择一组 QIs 提供了基础，用于持续、标准化地监测儿童癌症系统各个方面的质量。
