Healthcare quality indicator; Hospital volume; Neoplasm staging; Ovarian epithelial carcinoma; Ovarian neoplasms; Oncology; General Medicine; Surgery
Abstract :
[en] [en] BACKGROUND: Different sets of quality indicators are used to identify areas for improvement in ovarian cancer care. This study reports transparently on how (surgical) indicators were measured and on the association between hospital volume and indicator results in Belgium, a country setting without any centralisation of ovarian cancer care.
METHODS: From the population-based Belgian Cancer Registry, patients with a borderline malignant or invasive epithelial ovarian tumour diagnosed between 2014 and 2018 were selected and linked to health insurance and vital status data (n = 5119). Thirteen quality indicators on diagnosis and treatment were assessed and the association with hospital volume was analysed using logistic regression adjusted for case-mix.
RESULTS: The national results for most quality indicators on diagnosis and systemic therapy were around the predefined target value. Other indicators showed results below the benchmark: genetic testing, completeness of staging surgery, lymphadenectomy with at least 20 pelvic/para-aortic lymph nodes removed, and timely start of chemotherapy after surgery (within 42 days). Ovarian cancer care in Belgium is dispersed over 100 hospitals. Lower volume hospitals showed poorer indicator results compared to higher volume hospitals for lymphadenectomy, staging, timely start of chemotherapy and genetic testing. In addition, surgery for advanced stage tumours was performed less often in lower volume hospitals.
CONCLUSIONS: The indicators that showed poorer results on a national level were also those with poorer results in lower-volume hospitals compared to higher-volume hospitals, consequently supporting centralisation. International benchmarking is hampered by different (surgical) definitions between countries and studies.
Disciplines :
Surgery Oncology Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Bourgeois, Jolyce ; Belgian Health Care Knowledge Centre (KCE), Kruidtuinlaan 55, Brussels, B-1000, Belgium. Electronic address: Jolyce.bourgeois@kce.fgov.be
Peacock, Hanna M; Belgian Cancer Registry, Koningsstraat 215, Bus7, Brussels, B-1210, Belgium
Savoye, Isabelle ; Belgian Health Care Knowledge Centre (KCE), Kruidtuinlaan 55, Brussels, B-1000, Belgium
De Gendt, Cindy ; Belgian Cancer Registry, Koningsstraat 215, Bus7, Brussels, B-1210, Belgium
Leroy, Roos; Belgian Health Care Knowledge Centre (KCE), Kruidtuinlaan 55, Brussels, B-1000, Belgium
Silversmit, Geert ; Belgian Cancer Registry, Koningsstraat 215, Bus7, Brussels, B-1210, Belgium
Stordeur, Sabine; Belgian Health Care Knowledge Centre (KCE), Kruidtuinlaan 55, Brussels, B-1000, Belgium
de Sutter, Philippe; Department Gynaecology-Oncology, UZ Brussel - VUB, Brussels, B-1210, Belgium
Goffin, Frédéric ; Centre Hospitalier Universitaire de Liège - CHU > > Service de gynécologie-obstétrique (CHR)
Luyckx, Mathieu ; Service de Gynécologie et Andrologie and Institut Roi Albert II, Cliniques Universitaires Saint-Luc, UCLouvain, Brussel, Belgium
Orye, Guy; Department of Obstetrics and Gynecology, Jessa Hospital, Hasselt, Belgium
Van Dam, Peter; Division of Gynecological Oncology, Multidisciplinary Oncologic Centre, Antwerp University Hospital, Wilrijkstraat 10, Edegem, B-2650, Belgium, Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, Universiteitsplein 1, Wilrijk, B-2610, Belgium
Van Gorp, Toon; University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium
Verleye, Leen ; Belgian Health Care Knowledge Centre (KCE), Kruidtuinlaan 55, Brussels, B-1000, Belgium
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