Quality of care for lung cancer in Taiwan: a pattern of care based on core measures in the Taiwan Cancer Database registry.
OBJECTIVE
To investigate the quality of care (QOC) for lung cancer in Taiwan, as measured by pattern of care (POC) variation.


METHODS
Based on core measures in the Taiwan Cancer Database (TCDB) registry, QOC for lung cancer was measured as variation in POC for 16 selected core measures for different hospital characteristics. Statistical significance in variation was evaluated by the Chi-squared test.


RESULTS
Among the 26 participating hospitals (one excluded as an outlier), 6624 cases of lung cancer were reported in 2004. Among the 16 core measures (6 in the diagnostic and 10 in the therapeutic domain), no significant variation in POC was noted in 12 in northern and non-northern hospitals. However, significant variation in POC was noted for most (5/6) of the core measures in the diagnostic domain for other hospital characteristics (large vs. small, medical center vs. regional hospital, public vs. private). Increasing utilization of tissue diagnosis, diagnostic computed tomography (CT), and CT or magnetic resonance imaging for staging advanced non-small cell lung cancer was noted in the four participating hospitals from 2002 to 2004.


CONCLUSIONS
It is very likely that significant variation in QOC for lung cancer in Taiwan exists among different types but not locations of hospitals, at least in the diagnostic domain. The introduction of internal benchmarking (TCDB and core measures) was associated with some changes, at least in some diagnostic domains, which may lead to improvement in QOC for lung cancer in Taiwan.
Chien
Chun-Ru
CR
Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan.
Tsai
Chun-Ming
CM
Tang
Siew-Tzuh
ST
Chung
Kuo-Piao
KP
Chiu
Chao-Hua
CH
Lai
Mei-Shu
MS
D019992:Databases as Topic; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D011787:Quality of Health Care; D012042:Registries; D013624:Taiwan / Q000453:epidemiology