The use of quality indicators (QIs) to evaluate the oncologic care in CCCN: a systematic review

• Published in: European journal of public health Vol. 29; no. Supplement_4
• Main Authors: Cocchiara, R A, Mannocci, A, Cianfanelli, S, Sestili, C, D’Egidio, V, Lia, L, Backhaus, I, Dorelli, B, Federici, A, La Torre, G
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.11.2019; Oxford Publishing Limited (England)
• Subjects: Breast; Breast cancer; Cancer; Cooperation; Delphi method; Diagnosis; Domains; Health services; Indicators; Integrated approach; Life expectancy; Life span; Lung cancer; Organs; Palliative care; Participation; Patients; Prevention; Public health; Quality control; Quality of care; Rehabilitation; Systematic review
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckz185.278

Abstract Due to the increase of life expectancy for cancer patients, it has become necessary to implement complete and economically sustainable clinical care pathways that integrate different professional competences. The Comprehensive Cancer Care Network (CCCN) model consists of multiple specialized structures that cooperate for cancer patients care. Quality Indicators (QIs) represent valid and reliable tools of evaluation that allow a standardized comparison among different structures. The aim of this systematic review was to highlight a wide and complete description of the implemented QIs within the CCCNs and to identify and analyze methodologies used for the development of QIs. The literature was performed investigating two databases (PubMed and Scopus) and the search identified 7342 studies. After duplicate removal, title and abstract screening, and full text evaluation, 46 studies were included in the study. Most QIs were implemented in USA, Germany and Italy where the CCCN approach seems to be well defined. Eighty -two QIs concerned diagnosis, 260 concerned treatment, 7 concerned prevention, 29 about follow up, 71 about palliative care, 12 concerned rehabilitation and 7 research. The majority of the identified QIs belonged to the process domain, followed by the structure ones. Excluding QIs related to the management of cancer in general, the most represented organs resulted breast, colorectum and lung. Overall, it can be stated that the most represented categories of QIs concerned diagnosis and treatment. Furthermore, also the palliative care domain appeared very represented. Regarding the methodology of the QIs development, a consensus approach among experts and the Delphi method were the most frequently used methodologies. Only a few studies included the participation of patients for the implementation of the QIs. This systematic review provides a synthesis of existing QIs related to the setting of integrated oncological care Key messages The CCCN has been recognized as an ideal model for structuring the process of care that guarantees a complete and integrated approach for the management of oncological patients. Quality Indicators represent valid and reliable tools that should be used to perform a standardized comparison among different healthcare systems and to guarantee a homogeneous quality of care.