title: Factors associated with quality of care for patients with pancreatic cancer in Australia.
abstract: OBJECTIVE
  To develop a composite score for the quality of care for patients with pancreatic cancer in Australia; to determine whether it was affected by patient and health service-related factors; to assess whether the score and survival were correlated.
  
  
  METHODS
  We reviewed medical records of patients diagnosed with pancreatic cancer during July 2009 - June 2011 and notified to the Queensland and New South Wales cancer registries.
  
  
  METHODS
  Participants were allocated proportional quality of care scores based on indicators derived from a Delphi process, ranging from 0 (lowest) to 1 (highest quality care). Associations between patient and health service-related factors and the score were tested by linear regression, and associations between the score and survival with Kaplan-Meier and Cox proportional hazards methods.
  
  
  RESULTS
  Proportional quality of care scores were assigned to 1571 patients. Scores for patients living in rural areas were significantly lower than for those in major cities (adjusted difference, 11%; 95% CI, 8-13%); they were higher for patients in the least socio-economically disadvantaged areas (v most disadvantaged areas: 8% higher; 95% CI, 6-11%), who were younger, had better Eastern Cooperative Oncology Group performance status, or who first presented to a hospital with a high pancreatic case volume. Higher scores were associated with improved survival; after adjusting for patient-related factors, each 10 percentage point increase in the score reduced the risk of dying by 6% (hazard ratio, 0.94; 95% CI, 0.91-0.97).
  
  
  CONCLUSIONS
  Geographic category of residence may influence the quality of care received by patients with pancreatic cancer, and survival could be improved if they received optimal care.
authors.affiliation: QIMR Berghofer Medical Research Institute, Brisbane, QLD elizabeth.burmeister@qimrberghofer.edu.au.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Burmeister
authors.affiliation: Cancer Council NSW, Sydney, NSW.
authors.forename: Dianne L
authors.initials: DL
authors.lastname: O'Connell
authors.affiliation: QIMR Berghofer Medical Research Institute, Brisbane, QLD.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Jordan
authors.affiliation: Prince of Wales Hospital, Sydney, NSW.
authors.forename: David
authors.initials: D
authors.lastname: Goldstein
authors.affiliation: University of Western Sydney, Penrith, NSW.
authors.forename: Neil
authors.initials: N
authors.lastname: Merrett
authors.affiliation: Royal Brisbane and Women's Hospital, Brisbane, QLD.
authors.forename: David K
authors.initials: DK
authors.lastname: Wyld
authors.affiliation: QIMR Berghofer Medical Research Institute, Brisbane, QLD.
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Beesley
authors.affiliation: University of Sydney, Sydney, NSW.
authors.forename: Helen M
authors.initials: HM
authors.lastname: Gooden
authors.affiliation: Queensland University of Technology, Brisbane, QLD.
authors.forename: Monika
authors.initials: M
authors.lastname: Janda
authors.affiliation: QIMR Berghofer Medical Research Institute, Brisbane, QLD.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Neale
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D010190:Pancreatic Neoplasms / Q000401:mortality*; D016016:Proportional Hazards Models; D011787:Quality of Health Care / Q000592:standards*; D011793:Queensland; D012042:Registries; D017678:Sex Distribution; D035862:Vulnerable Populations