Completeness of American Cancer Registry Treatment Data: Implications for Quality of Care Research
Completeness of American Cancer Registry Treatment Data: Implications for Quality of Care Research
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DOI：
10.1016/j.jamcollsurg.2012.12.016
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发表时间：
2013-03-01
影响因子：
5.2
通讯作者：
Edge, Stephen B.
中科院分区：
文献类型：
--
作者：
Mallin, Katherine;Palis, Bryan E.;Edge, Stephen B.
背景：评估和提高癌症护理质量需要有关癌症分期和治疗的完整信息。医院登记处是这项工作的关键工具，但 20 世纪 90 年代的报告显示，它们未能确定门诊治疗的主要部分，包括化疗、内分泌治疗和放射治疗。这可能会限制它们评估护理模式和质量的价值。为了确定近年来登记数据的完整性，我们将俄亥俄州 2 个私人付款人的行政索赔与国家癌症数据库和俄亥俄州癌症发病率和监测系统联系起来。方法：通过国家癌症数据库、俄亥俄州癌症发病率和监测系统以及使用 ICD-9 和 CPT 程序的付款人保险索赔的联系，确定了 2004-2006 年诊断的俄亥俄州居民中乳腺癌和结直肠癌的发病率。 代码和 ICD-9 诊断代码。链接是通过患者人口统计数据、手术日期和医院设施来完成的。使用 kappa 统计数据对索赔和登记数据中发现的治疗进行比较和评估。结果：分析队列包括 2,552 例乳腺癌病例和 822 例结直肠癌病例。结果显示，乳房手术类型的一致性较高，结直肠手术类型的一致性较高。对于乳腺病例，登记处记录了 87% 的化疗、86% 的放疗和 64% 的内分泌治疗索赔。对于结直肠癌病例，登记处记录了理赔中 83% 的化疗和 84% 的放疗数据。 结论：与理赔数据相比，2004-2006 年诊断的乳腺癌和结肠癌医院登记处记录了约 85% 的放疗和化疗数据，这一比例高于早期报告。这些发现为那些使用注册数据研究全身和放射治疗护理的模式和质量的人提供了方向和警示。 （J Am Coll Surg 2013；216：428-437。(C) 2013 年，美国外科医师学会）
BACKGROUND: Evaluating and improving the quality of cancer care requires complete information on cancer stage and treatment. Hospital-based registries are a key tool in this effort, but reports in the 1990s showed that they fail to identify a major fraction of outpatient-administered treatment, including chemotherapy, endocrine therapy, and radiation. This can limit their value for evaluating patterns and quality of care. To determine the completeness of registry data in more recent years, we linked administrative claims from 2 private payers in Ohio to the National Cancer Data Base and Ohio Cancer Incidence and Surveillance System.METHODS: Incident breast and colorectal cancers among Ohio residents diagnosed in 2004-2006 were identified from linkage of the National Cancer Data Base, Ohio Cancer Incidence and Surveillance System, and payer insurance claims using ICD-9 and CPT procedure codes, and ICD-9 diagnosis codes. Linkage was accomplished using patient demographics, surgery dates, and hospital facility. Treatment found in claims and registry data were compared and assessed using the kappa statistic.RESULTS: The analytic cohort included 2,552 breast and 822 colorectal cases. Results showed high agreement for breast surgery type, and moderately high agreement for colorectal surgery type. For breast cases, the registries captured 87% of chemotherapy, 86% of radiation, and 64% of endocrine treatment in claims. For colorectal cases, the registry captured 83% of chemotherapy and 84% of radiation in claims.CONCLUSIONS: Hospital-based registries for breast and colon cancer diagnosed in 2004-2006 captured about 85% of radiation and chemotherapy data compared with claims data, a higher percentage than earlier reports. These findings provide direction and a cautionary note to those using registry data for study of patterns and quality of systemic and radiation therapy care. (J Am Coll Surg 2013;216:428-437. (C) 2013 by the American College of Surgeons)