title: Quality evaluation of medical care for breast cancer in Japan.
abstract: OBJECTIVE
  The purpose of this study is to measure adherence rate to the quality indicators (QI) in clinical practice to evaluate the quality of care for breast cancer patients in Japan.
  
  
  METHODS
  A retrospective record review.
  
  
  METHODS
  Two hundred twenty-four designated breast cancer care hospitals throughout Japan.
  
  
  METHODS
  A total of 15 227 patients diagnosed with breast cancer in 2005.
  
  
  METHODS
  The adherence rate of seven items that correspond to QIs of medical care, which were developed using an adaptation of RAND/UCLA (University of California, Los Angeles) appropriateness method.
  
  
  RESULTS
  The lowest quality score was the drug therapy adherence to the St. Gallen consensus recommendations, for which the overall quality score 52.8%. The highest quality score was the adherence rate of hormone receptor testing, for which overall quality score was 97.8%. The greatest variations across facilities were for HER-2 testing and for radiation therapy after breast-conserving surgery. The least variation was for hormone receptor testing.
  
  
  CONCLUSIONS
  There was a range of measurements for the adherence rate to each QI, suggesting that the desired standards of care had not necessarily pervaded all facilities. It is necessary to strive for widespread implementation of QIs and realization of the significance of measuring the medical care quality among physicians treating breast cancer.
authors.affiliation: Department of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Mukai
authors.affiliation: Division of Health Services Research, Center for Cancer Control and information Service, National Cancer Center, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Higashi
authors.affiliation: Department of Breast and Medical Oncology, National Cancer Center Hospital East, Chiba, Japan.
authors.forename: Masaoki
authors.initials: M
authors.lastname: Sasaki
authors.affiliation: Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Sobue
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007564:Japan / Q000453:epidemiology; D010349:Patient Compliance; D019984:Quality Indicators, Health Care; D012042:Registries; D012189:Retrospective Studies
keywords: breast cancer; guideline and quality indicator; medical care