title: Quality of gastric cancer care in designated cancer care hospitals in Japan.
abstract: OBJECTIVE
  To develop a set of process-of-care quality indicators (QIs) that would cover a wide range of gastric cancer care modalities and to examine the current state of the quality of care provided by designated cancer care hospitals in Japan.
  
  
  METHODS
  A retrospective medical record review.
  
  
  METHODS
  Eighteen designated cancer care hospitals throughout Japan.
  
  
  METHODS
  A total of 1685 patients diagnosed with gastric cancer in 2007.
  
  
  METHODS
  Provision of care to eligible patients as described in the 29 QIs, which were developed using an adaptation of the RAND/UCLA (University of California, Los Angeles) appropriateness method by a panel of nationally recognized experts in Japan.
  
  
  RESULTS
  Overall, the patients received 68.3% of the care processes recommended by the QIs. While 'deep venous thrombosis prophylaxis before major surgery' was performed for 99% of the cases, 'documentation before endoscopic resection' was completed for only 12% of the cases. The chemotherapy care was less likely to meet the QI standards (61%) than pre-therapeutic care (76%), surgical treatment (66%) and endoscopic resection (71%; overall difference: P < 0.001). A comparison based on the types of care showed that documentation and patient explanation were performed less frequently (60 and 53%, respectively) than were diagnostic and therapeutic processes as recommended in the QIs (85%; overall P < 0.001).
  
  
  CONCLUSIONS
  Although many required care processes were provided, some areas with room for improvement were revealed, especially with respect to chemotherapy, documentation and patient explanation. Continuous efforts to improve the quality and develop a system to monitor this progress would be beneficial in Japan.
authors.affiliation: Department of Public Health/Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan. higashi@m.u-tokyo.ac.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Higashi
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Nakamura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimada
authors.forename: Tetsu
authors.initials: T
authors.lastname: Shinkai
authors.forename: Toru
authors.initials: T
authors.lastname: Muranaka
authors.forename: Wataru
authors.initials: W
authors.lastname: Kamiike
authors.forename: Eiji
authors.initials: E
authors.lastname: Mekata
authors.forename: Ken
authors.initials: K
authors.lastname: Kondo
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Wada
authors.forename: Hironori
authors.initials: H
authors.lastname: Sakai
authors.forename: Mikinobu
authors.initials: M
authors.lastname: Ohtani
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sugiura
authors.forename: Shunichi
authors.initials: S
authors.lastname: Higashide
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Haga
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Kinoshita
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ezaki
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hanada
authors.forename: Fujio
authors.initials: F
authors.lastname: Makita
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Sobue
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamura
mesh_terms: D000368:Aged; D002173:Cancer Care Facilities / Q000458:organization & administration* / Q000592:standards; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017064:Process Assessment, Health Care; D019984:Quality Indicators, Health Care; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*
keywords: cancer; cancer control in Japan; gastric cancer; quality indicators; quality measurements