How to judge the cancer services benefit component of your health insurance plan.
BACKGROUND
Members of the oncology community, rich in data from years of published clinical research, epidemiology, and tumor registry information, expect businesses to evaluate the quality of cancer care using classic scientific methods. However, businesses lack sophistication in these data and tend to use significantly different criteria relating to cost, service, and access. Logistical problems also abound, such as the wide variety of cancers, small sample sizes, and the frequency with which patients change insurance plans.


METHODS
Adapting an approach first proposed by Donabedian employing criteria that can be measured, easily gathered, and whose presence/absence can be interpreted as having a consequence for patient care, the author proposes a system of evaluating cancer health care benefits.


CONCLUSIONS
Recognizing that classic outcomes analysis is too complex and inappropriate for business, companies and oncology providers may be able to develop obtainable measures whose presence or absence has intuitive and documented relation to the quality of cancer care.
Mortenson
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Association of Community Cancer Centers, Rockville, MD 20852, USA.
D003657:Decision Making; D006264:Health Benefit Plans, Employee / Q000592:standards*; D017048:Health Care Costs; D006297:Health Services Accessibility; D006801:Humans; D007342:Insurance Benefits; D019458:Insurance Coverage / Q000592:standards*; D008329:Managed Care Programs / Q000191:economics / Q000592:standards; D008495:Medical Oncology / Q000191:economics* / Q000592:standards*; D017063:Outcome Assessment, Health Care; D019984:Quality Indicators, Health Care; D014481:United States