Combining process indicators to evaluate quality of care for surgical patients with colorectal cancer

Are scores consistent with short-term outcome?

Journal article (2012)

Authors

N. E. Kolfschoten Leiden University Medical Center
G. A. Gooiker Leiden University Medical Center
M. W.J.M. Wouters Netherlands Cancer Institute
R.A.E.M. Tollenaar Leiden University Medical Center
Esther Bastiaannet Leiden University Medical Center
N.K. van Leersum Leiden University Medical Center
C. J.H. van de Velde Leiden University Medical Center
E. H. Eddes Deventer Hospitals
P.J. Marang-van de Mheen Leiden University Medical Center
J. Kievit Leiden University Medical Center
Erwin van der Harst Maasstad Hospital
T. Wiggers University Medical Center Groningen
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Published Date

2012

Language

English

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Abstract

Objective: To determine if composite measures based on process indicators are consistent with short-term outcome indicators in surgical colorectal cancer care. Design: Longitudinal analysis of consistency between composite measures based on process indicators and outcome indicators for 85 Dutch hospitals. Setting: The Dutch Surgical Colorectal Audit database, the Netherlands. Participants: 4732 elective patients with colon carcinoma and 2239 with rectum carcinoma treated in 85 hospitals were included in the analyses. Main outcome measures: All available process indicators were aggregated into five different composite measures. The association of the different composite measures with risk-adjusted postoperative mortality and morbidity was analysed at the patient and hospital level. Results: At the patient level, only one of the composite measures was negatively associated with morbidity for rectum carcinoma. At the hospital level, a strong negative association was found between composite measures and hospital mortality and morbidity rates for rectum carcinoma (p<0.05), and hospital morbidity rates for colon carcinoma. Conclusions: For individual patients, a high score on the composite measures based on process indicators is not associated with better short-term outcome. However, at the hospital level, a good score on the composite measures based on process indicators was consistent with more favourable risk-adjusted short-term outcome rates.