NQF Colon Cancer Quality Metric Performance: How Are Hospitals Measuring Up?
Annals of Surgery (09/16) Mason, Meredith C.; Chang, George J.; Petersen, Laura A.
The aim of this study was to examine the impact of care at high-performing hospitals using National Quality Forum (NQF) colon cancer metrics. The NQF's colon cancer quality indicators include evaluating at least 12 lymph nodes (LNs), adjuvant chemotherapy (AC) for stage III patients, and AC within four months of diagnosis. The retrospective cohort study included 218,186 patients with resected stage I to III colon cancer in the National Cancer Data Base (2004–2012). Researchers identified high-performing hospitals—those with at least 75 percent achievement—with the proportion of patients achieving each measure. According to the data, 45.9 percent of hospitals performed well on all three NQF colon cancer measures concurrently. Only hospital LN performance improved, rising from 15.8 percent in 2004 to 80.7 percent in 2012. For patients treated at hospitals with high performance on three, two, one, and no metrics, five-year survival was 75 percent, 72.3 percent, 72.5 percent, and 69.5 percent, respectively. Care at hospitals with high metric performance was linked to a lower risk of death in a dose-response fashion, while performance on metrics in combination was also associated with lower risk of death. No such association was seen for individual measures, however. "Quality improvement efforts should shift focus from individual measures to defining composite measures encompassing the overall multimodal care pathway and capturing successful transitions from one care modality to another," the researchers conclude.
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