Variation in integrated head and neck cancer care: Impact of patient and hospital characteristics

Lydia F. J. van Overveld, Robert P. Takes, Jozé C. C. Braspenning, Robert J. Baatenburg de Jong, Jan P. de Boer, John J. A. Brouns, Rolf J. Bun, Eric A. Dik, Boukje A. C. van Dijk, Robert J. J. van Es, Frank J. P. Hoebers, Barry Kolenaar, Arvid Kropveld, Ton P. M. Langeveld, Hendrik P. Verschuur, Jan G. A. M. de Visscher, Stijn van Weert, Max J. H. Witjes, Ludi E. Smeele, Matthias A. W. Merkx & 1 others Rosella P. M. G. Hermens

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Monitoring and effectively improving oncologic integrated care requires dashboard information based on quality registrations. The dashboard includes evidence-based quality indicators (QIs) that measure quality of care. This study aimed to assess the quality of current integrated head and neck cancer care with QIs, the variation between Dutch hospitals, and the influence of patient and hospital characteristics. Methods: Previously, 39 QIs were developed with input from medical specialists, allied health professionals, and patients’ perspectives. QI scores were calculated with data from 1,667 curatively treated patients in 8 hospitals. QIs with a sample size of >400 patients were included to calculate reliable QI scores. We used multilevel analysis to explain the variation. Results: Current care varied from 29% for the QI about a case manager being present to discuss the treatment plan to 100% for the QI about the availability of a treatment plan. Variation between hospitals was small for the QI about patients discussed in multidisciplinary team meetings (adherence: 95%, range 88%–98%), but large for the QI about malnutrition screening (adherence: 50%, range 2%–100%). Higher QI scores were associated with lower performance status, advanced tumor stage, and tumor in the oral cavity or oropharynx at the patient level, and with more curatively treated patients (volume) at hospital level. Conclusions: Although the quality registration was only recently launched, it already visualizes hospital variation in current care. Four determinants were found to be influential: tumor stage, performance status, tumor site, and volume. More data are needed to assure stable results for use in quality improvement.
LanguageEnglish
Pages1491-1498
JournalJournal of the national comprehensive cancer network
Volume16
Issue number12
DOIs
Publication statusPublished - 2018

Cite this

van Overveld, L. F. J., Takes, R. P., Braspenning, J. C. C., Baatenburg de Jong, R. J., de Boer, J. P., Brouns, J. J. A., ... Hermens, R. P. M. G. (2018). Variation in integrated head and neck cancer care: Impact of patient and hospital characteristics. Journal of the national comprehensive cancer network, 16(12), 1491-1498. https://doi.org/10.6004/jnccn.2018.7061
van Overveld, Lydia F. J. ; Takes, Robert P. ; Braspenning, Jozé C. C. ; Baatenburg de Jong, Robert J. ; de Boer, Jan P. ; Brouns, John J. A. ; Bun, Rolf J. ; Dik, Eric A. ; van Dijk, Boukje A. C. ; van Es, Robert J. J. ; Hoebers, Frank J. P. ; Kolenaar, Barry ; Kropveld, Arvid ; Langeveld, Ton P. M. ; Verschuur, Hendrik P. ; de Visscher, Jan G. A. M. ; van Weert, Stijn ; Witjes, Max J. H. ; Smeele, Ludi E. ; Merkx, Matthias A. W. ; Hermens, Rosella P. M. G. / Variation in integrated head and neck cancer care: Impact of patient and hospital characteristics. In: Journal of the national comprehensive cancer network. 2018 ; Vol. 16, No. 12. pp. 1491-1498.
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abstract = "Background: Monitoring and effectively improving oncologic integrated care requires dashboard information based on quality registrations. The dashboard includes evidence-based quality indicators (QIs) that measure quality of care. This study aimed to assess the quality of current integrated head and neck cancer care with QIs, the variation between Dutch hospitals, and the influence of patient and hospital characteristics. Methods: Previously, 39 QIs were developed with input from medical specialists, allied health professionals, and patients’ perspectives. QI scores were calculated with data from 1,667 curatively treated patients in 8 hospitals. QIs with a sample size of >400 patients were included to calculate reliable QI scores. We used multilevel analysis to explain the variation. Results: Current care varied from 29{\%} for the QI about a case manager being present to discuss the treatment plan to 100{\%} for the QI about the availability of a treatment plan. Variation between hospitals was small for the QI about patients discussed in multidisciplinary team meetings (adherence: 95{\%}, range 88{\%}–98{\%}), but large for the QI about malnutrition screening (adherence: 50{\%}, range 2{\%}–100{\%}). Higher QI scores were associated with lower performance status, advanced tumor stage, and tumor in the oral cavity or oropharynx at the patient level, and with more curatively treated patients (volume) at hospital level. Conclusions: Although the quality registration was only recently launched, it already visualizes hospital variation in current care. Four determinants were found to be influential: tumor stage, performance status, tumor site, and volume. More data are needed to assure stable results for use in quality improvement.",
author = "{van Overveld}, {Lydia F. J.} and Takes, {Robert P.} and Braspenning, {Joz{\'e} C. C.} and {Baatenburg de Jong}, {Robert J.} and {de Boer}, {Jan P.} and Brouns, {John J. A.} and Bun, {Rolf J.} and Dik, {Eric A.} and {van Dijk}, {Boukje A. C.} and {van Es}, {Robert J. J.} and Hoebers, {Frank J. P.} and Barry Kolenaar and Arvid Kropveld and Langeveld, {Ton P. M.} and Verschuur, {Hendrik P.} and {de Visscher}, {Jan G. A. M.} and {van Weert}, Stijn and Witjes, {Max J. H.} and Smeele, {Ludi E.} and Merkx, {Matthias A. W.} and Hermens, {Rosella P. M. G.}",
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language = "English",
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van Overveld, LFJ, Takes, RP, Braspenning, JCC, Baatenburg de Jong, RJ, de Boer, JP, Brouns, JJA, Bun, RJ, Dik, EA, van Dijk, BAC, van Es, RJJ, Hoebers, FJP, Kolenaar, B, Kropveld, A, Langeveld, TPM, Verschuur, HP, de Visscher, JGAM, van Weert, S, Witjes, MJH, Smeele, LE, Merkx, MAW & Hermens, RPMG 2018, 'Variation in integrated head and neck cancer care: Impact of patient and hospital characteristics', Journal of the national comprehensive cancer network, vol. 16, no. 12, pp. 1491-1498. https://doi.org/10.6004/jnccn.2018.7061

Variation in integrated head and neck cancer care: Impact of patient and hospital characteristics. / van Overveld, Lydia F. J.; Takes, Robert P.; Braspenning, Jozé C. C.; Baatenburg de Jong, Robert J.; de Boer, Jan P.; Brouns, John J. A.; Bun, Rolf J.; Dik, Eric A.; van Dijk, Boukje A. C.; van Es, Robert J. J.; Hoebers, Frank J. P.; Kolenaar, Barry; Kropveld, Arvid; Langeveld, Ton P. M.; Verschuur, Hendrik P.; de Visscher, Jan G. A. M.; van Weert, Stijn; Witjes, Max J. H.; Smeele, Ludi E.; Merkx, Matthias A. W.; Hermens, Rosella P. M. G.

In: Journal of the national comprehensive cancer network, Vol. 16, No. 12, 2018, p. 1491-1498.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Variation in integrated head and neck cancer care: Impact of patient and hospital characteristics

AU - van Overveld, Lydia F. J.

AU - Takes, Robert P.

AU - Braspenning, Jozé C. C.

AU - Baatenburg de Jong, Robert J.

AU - de Boer, Jan P.

AU - Brouns, John J. A.

AU - Bun, Rolf J.

AU - Dik, Eric A.

AU - van Dijk, Boukje A. C.

AU - van Es, Robert J. J.

AU - Hoebers, Frank J. P.

AU - Kolenaar, Barry

AU - Kropveld, Arvid

AU - Langeveld, Ton P. M.

AU - Verschuur, Hendrik P.

AU - de Visscher, Jan G. A. M.

AU - van Weert, Stijn

AU - Witjes, Max J. H.

AU - Smeele, Ludi E.

AU - Merkx, Matthias A. W.

AU - Hermens, Rosella P. M. G.

PY - 2018

Y1 - 2018

N2 - Background: Monitoring and effectively improving oncologic integrated care requires dashboard information based on quality registrations. The dashboard includes evidence-based quality indicators (QIs) that measure quality of care. This study aimed to assess the quality of current integrated head and neck cancer care with QIs, the variation between Dutch hospitals, and the influence of patient and hospital characteristics. Methods: Previously, 39 QIs were developed with input from medical specialists, allied health professionals, and patients’ perspectives. QI scores were calculated with data from 1,667 curatively treated patients in 8 hospitals. QIs with a sample size of >400 patients were included to calculate reliable QI scores. We used multilevel analysis to explain the variation. Results: Current care varied from 29% for the QI about a case manager being present to discuss the treatment plan to 100% for the QI about the availability of a treatment plan. Variation between hospitals was small for the QI about patients discussed in multidisciplinary team meetings (adherence: 95%, range 88%–98%), but large for the QI about malnutrition screening (adherence: 50%, range 2%–100%). Higher QI scores were associated with lower performance status, advanced tumor stage, and tumor in the oral cavity or oropharynx at the patient level, and with more curatively treated patients (volume) at hospital level. Conclusions: Although the quality registration was only recently launched, it already visualizes hospital variation in current care. Four determinants were found to be influential: tumor stage, performance status, tumor site, and volume. More data are needed to assure stable results for use in quality improvement.

AB - Background: Monitoring and effectively improving oncologic integrated care requires dashboard information based on quality registrations. The dashboard includes evidence-based quality indicators (QIs) that measure quality of care. This study aimed to assess the quality of current integrated head and neck cancer care with QIs, the variation between Dutch hospitals, and the influence of patient and hospital characteristics. Methods: Previously, 39 QIs were developed with input from medical specialists, allied health professionals, and patients’ perspectives. QI scores were calculated with data from 1,667 curatively treated patients in 8 hospitals. QIs with a sample size of >400 patients were included to calculate reliable QI scores. We used multilevel analysis to explain the variation. Results: Current care varied from 29% for the QI about a case manager being present to discuss the treatment plan to 100% for the QI about the availability of a treatment plan. Variation between hospitals was small for the QI about patients discussed in multidisciplinary team meetings (adherence: 95%, range 88%–98%), but large for the QI about malnutrition screening (adherence: 50%, range 2%–100%). Higher QI scores were associated with lower performance status, advanced tumor stage, and tumor in the oral cavity or oropharynx at the patient level, and with more curatively treated patients (volume) at hospital level. Conclusions: Although the quality registration was only recently launched, it already visualizes hospital variation in current care. Four determinants were found to be influential: tumor stage, performance status, tumor site, and volume. More data are needed to assure stable results for use in quality improvement.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85058727127&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30545996

U2 - 10.6004/jnccn.2018.7061

DO - 10.6004/jnccn.2018.7061

M3 - Article

VL - 16

SP - 1491

EP - 1498

JO - Journal of the national comprehensive cancer network

T2 - Journal of the national comprehensive cancer network

JF - Journal of the national comprehensive cancer network

SN - 1540-1405

IS - 12

ER -