Breast cancer quality of care in Taiwan in relation to hospital volume: a population-based cohort study

6066 Background: Defining, measuring and monitoring quality of care is a facet of health services research that is growing in importance. Breast cancer offers a disease model to examine quality end-of-life (EOL) care provided to women. Administrative data have the unique potential to provide population-based measures of quality of care. The objective of this study was to assess the feasibility of using routinely-collected administrative data to measure quality EOL care for breast cancer patients. Methods: A cohort of all women in Nova Scotia who died of breast cancer between 01/01/1998 and 31/12/2002 was assembled from the Cancer Registry and Vital Statistics data. The EOL study period was defined as the last 6 months of life. A total of 864 women met the eligibility criteria. After a literature review, an expert panel identified 19 indicators that were potentially measurable through administrative data. Physician billings, hospital discharge abstracts and seniors pharmacare data, supplemented by clinical datasets, were utilized to calculate the statistics with which to represent the indicators. Results: Benchmark measures of care across the cohort show 63.4% died in a hospital, a mean continuity of care index of 0.786, and the mean number of inpatient days in the last 30 was 9.9. Indicators of aggressive care include 9.3% had chemotherapy in the last 14 days, 5.6% had more than 1 emergency room visit in the last 30 days, and 29.1% had more than 14 inpatient days in the last 30 days. Conclusions: Weaknesses of using these data include: 1) fixed variables with an administrative rather than a clinical objective; 2) lack of comprehensiveness of various datasets; and 3) the use of billings data where increasingly physicians are paid through methods other than fee-for-service. Strengths of this approach are: 1) population-based cohort; 2) comprehensiveness of cohort selection through the provincial Vital Statistics file; and 3) accessibility of data. No significant financial relationships to disclose.

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Blood Pressure Control and Other Quality of Care Metrics for Patients with Obesity and Diabetes: A Population-Based Cohort Study

High Blood Pressure & Cardiovascular Prevention ◽

10.1007/s40292-018-0284-x ◽

2018 ◽

Vol 25 (4) ◽

pp. 391-399

Author(s):

Jennifer T. Fink ◽

Elizabeth M. Magnan ◽

Heather M. Johnson ◽

Lauren M. Bednarz ◽

Glenn O. Allen ◽

...

Keyword(s):

Blood Pressure ◽

Cohort Study ◽

Quality Of Care ◽

Blood Pressure Control ◽

Pressure Control ◽

Population Based ◽

Obesity And Diabetes

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Period-specific mean annual hospital volume of radical cystectomy is associated with outcome and perioperative quality of care in Sweden – a nation-wide population based study

European Urology Supplements ◽

10.1016/s1569-9056(19)30960-1 ◽

2019 ◽

Vol 18 (1) ◽

pp. e1330

Author(s):

F. Liedberg ◽

O. Hagberg ◽

F. Aljabery ◽

T. Gårdmark ◽

A. Hosseini ◽

...

Keyword(s):

Quality Of Care ◽

Radical Cystectomy ◽

Hospital Volume ◽

Population Based ◽

Population Based Study ◽

Wide Population

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Quality of care and volume for patients with diabetes mellitus in the primary care setting: A population based retrospective cohort study

Diabetes Research and Clinical Practice ◽

10.1016/j.diabres.2016.07.029 ◽

2016 ◽

Vol 120 ◽

pp. 171-181 ◽

Cited By ~ 2

Author(s):

Carlos K.H. Wong ◽

Colman S.C. Fung ◽

Kenny Kung ◽

Eric Y.F. Wan ◽

Esther Y.T. Yu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Primary Care ◽

Cohort Study ◽

Quality Of Care ◽

Retrospective Cohort ◽

Care Setting ◽

Primary Care Setting ◽

Population Based ◽

Patients With Diabetes

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Timely access and quality of care in colorectal cancer: a population-based cohort study using administrative data

BMC Research Notes ◽

10.1186/1756-0500-6-355 ◽

2013 ◽

Vol 6 (1) ◽

Cited By ~ 5

Author(s):

Geoffrey Porter ◽

Robin Urquhart ◽

Cynthia Kendell ◽

Jingyu Bu ◽

Yarrow McConnell ◽

...

Keyword(s):

Colorectal Cancer ◽

Cohort Study ◽

Quality Of Care ◽

Administrative Data ◽

Population Based ◽

Timely Access ◽

Access And Quality

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A prospective cohort study of early discontinuation of adjuvant chemotherapy in women with breast cancer: the breast cancer quality of care study (BQUAL)

Breast Cancer Research and Treatment ◽

10.1007/s10549-016-3855-3 ◽

2016 ◽

Vol 158 (1) ◽

pp. 127-138 ◽

Cited By ~ 8

Author(s):

Alfred I. Neugut ◽

Grace Clarke Hillyer ◽

Lawrence H. Kushi ◽

Lois Lamerato ◽

Donna L. Buono ◽

...

Keyword(s):

Breast Cancer ◽

Cohort Study ◽

Quality Of Care ◽

Adjuvant Chemotherapy ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Early Discontinuation ◽

Care Study

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Determinants of community pharmacists’ quality of care: a population-based cohort study using pharmacy administrative claims data

BMJ Open ◽

10.1136/bmjopen-2017-015877 ◽

2017 ◽

Vol 7 (9) ◽

pp. e015877 ◽

Cited By ~ 4

Author(s):

Nancy Winslade ◽

Robyn Tamblyn

Keyword(s):

Cohort Study ◽

Quality Of Care ◽

Primary Outcome ◽

Claims Data ◽

Population Based ◽

Professional Services ◽

Administrative Claims ◽

Antihypertensive Medications ◽

Pharmacy Claims

ObjectiveTo determine if a prototype pharmacists’ services evaluation programme that uses linked community pharmacy claims and health administrative data to measure pharmacists’ performance can be used to identify characteristics of pharmacies providing higher quality of care.DesignPopulation-based cohort study using community pharmacy claims from 1 November 2009 to 30 June 2010.SettingAll community pharmacies in Quebec, Canada.Participants1742 pharmacies dispensing 8 655 348 antihypertensive prescriptions to 760 700 patients.Primary outcome measurePatient adherence to antihypertensive medications.PredictorsPharmacy level: dispensing workload, volume of pharmacist-provided professional services (eg, refusals to dispense, pharmacotherapy recommendations), pharmacy location, banner/chain, pharmacist overlap and within-pharmacy continuity of care. Patient level: sex, age, income, patient prescription cost, new/chronic therapy, single/multiple antihypertensive medications, single/multiple prescribers and single/multiple dispensing pharmacies. Dispensing level: prescription duration, time of day dispensed and antihypertensive class. Multivariate alternating logistic regression estimated predictors of the primary outcome, accounting for patient and pharmacy clustering.Results9.2% of dispensings of antihypertensive medications were provided to non-adherent patients. Male sex, decreasing age, new treatment, multiple prescribers and multiple dispensing pharmacies were risk factors for increased non-adherence. Pharmacies that provided more professional services were less likely to dispense to non-adherent hypertensive patients (OR: 0.60; 95% CI: 0.57 to 0.62) as were those with better scores on the Within-Pharmacy Continuity of Care Index. Neither increased pharmacists’ services for improving antihypertensive adherence per se nor increased pharmacist overlap impacted the odds of non-adherence. However, pharmacist overlap was strongly correlated with dispensing workload. There was significant unexplained variability among pharmacies belonging to different banners and chains.ConclusionsPharmacy administrative claims data can be used to calculate pharmacy-level characteristics associated with improved quality of care. This study supports the importance of pharmacist’s professional services and continuity of pharmacist’s care.

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