Quality assessment of colorectal cancer care: an international online model.
OBJECTIVE
We present an alternative approach to quality assessment in colorectal cancer, enabling a direct comparison of improvement at the level of the care provider.


METHODS
In 2000, a quality assessment project in colorectal cancer in Germany was started. Data were provided for every patient treated for colorectal cancer. The enrolment questionnaire described patient data, risk factors, reason for hospitalization, diagnostics prior to surgery, surgical procedures, intraoperative complications, general and surgical complications in postoperative period, pathological report and discharge status.


RESULTS
From 2000 to 2007, there were 57 429 patients included in the study. The total number of 372 hospitals that took part in the project varied from 153 to 281 per year. The overall resection rate for colon cancer was 97.1% and 94.8% for rectal cancer. Although the localization of rectal tumours did not vary, the percentage of abdominoperineal excisions fell from 26.1% in 2000 to 21.3% in 2008 (P < 0.001). Hospital mortality for colon cancer varied between 3.2% and 4.2% (P Pearson chi-square 0.032, linear-by-linear 0.257) and for rectal cancer between 2.7% and 3.7% (P Pearson chi-square 0.233). Patient age was not related to in-hospital mortality.


CONCLUSIONS
The proposed model of quality assessment shows validity and results comparable to population-based studies. It does not require support from the health care system, making its implementation possible in every hospital worldwide.
Mroczkowski
P
P
Department of General, Visceral and Vascular Surgery, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany. pawel.mroczkowski@med.ovgu.de
Kube
R
R
Schmidt
U
U
Gastinger
I
I
Lippert
H
H
D000005:Abdomen / Q000601:surgery; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019985:Benchmarking; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000592:standards; D009367:Neoplasm Staging; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D010502:Perineum / Q000601:surgery; D011044:Poland; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires