title: Quality of integrated care for patients with head and neck cancer: Development and measurement of clinical indicators.
abstract: BACKGROUND
  To improve the quality of integrated care, we developed indicators for assessing current practice in a large reference center for head and neck oncology.
  
  
  METHODS
  We defined a set of indicators based on integrated care literature, national evidence-based guidelines for patients with head and neck cancer, and the opinions of professionals and patients. We tested this set regarding assessment of current practice and clinimetric characteristics.
  
  
  RESULTS
  The final set consisted of 8 integrated care indicators and 23 specific indicators for patients with head and neck cancer. Current practice assessment produced high scores for the integrated care indicators, but the specific indicators showed room for improvement. The practice test showed that 9 indicators had good applicability.
  
  
  CONCLUSIONS
  The indicators, while based on evidence-based guidelines and the principles of integrated care, should incorporate patients' opinions and include a practice test. Our results show that the quality of integrated care for patients with head and neck cancer could be improved.
authors.affiliation: Centre for Quality of Care Research (WOK), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. m.ouwens@kwazo.umcn.nl
authors.forename: Mariëlle M M T J
authors.initials: MM
authors.lastname: Ouwens
authors.forename: Henri A M
authors.initials: HA
authors.lastname: Marres
authors.forename: Rosella R P
authors.initials: RR
authors.lastname: Hermens
authors.forename: Marlies M E
authors.initials: MM
authors.lastname: Hulscher
authors.forename: Frank J A
authors.initials: FJ
authors.lastname: van den Hoogen
authors.forename: Richard P
authors.initials: RP
authors.lastname: Grol
authors.forename: Hub C H
authors.initials: HC
authors.lastname: Wollersheim
mesh_terms: D003191:Comprehensive Health Care / Q000592:standards*; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D019317:Evidence-Based Medicine; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D019984:Quality Indicators, Health Care