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논문 기본 정보

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학술저널
저자정보
Tomone Watanabe (National Cancer Center) Mikio Mikami (Tokai University School of Medicine) Hidetaka Katabuchi (Faculty of Life Sciences Kumamoto University Kumamoto Japan) Shingo Kato (Saitama Medical Center) Masanori Kaneuchi (Department of Obstetrics and Gynecology Hokkaido University Graduate School of Medicine Sapporo J) Masahiro Takahashi (The University of Tokushima) Hidekatsu Nakai (Kinki University Hospital) Satoru Nagase (Yamagata University Faculty of Medicine) Hitoshi Niikura (Tohoku University) Masaki Mandai (Kyoto University Graduate School of Medicine) Yasuyuki Hirashima (Division of Gynecology Shizuoka Cancer) Hiroyuki Yanai (Okayama University Hospital) Wataru Yamagami (Keio University School of Medicine) Satoru Kamitani (enter for Cancer Control and Information Services National Cancer Center) Takahiro Higashi (Center for Cancer Control and Information Services National Cancer Center)
저널정보
대한부인종양학회 Journal of Gynecologic Oncology Journal of Gynecologic Oncology Vol.29 No.6
발행연도
2018.1
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1 - 10 (10page)

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Objective: We aimed to propose a set of quality indicators (QIs) based on the clinical guidelines for cervical cancer treatment published by The Japan Society of Gynecologic Oncology, and to assess adherence to standard-of-care as an index of the quality of care for cervical cancer in Japan. Methods: A panel of clinical experts devised the QIs using a modified Delphi method. Adherence to each QI was evaluated using data from a hospital-based cancer registry of patients diagnosed in 2013, and linked with insurance claims data, between October 1, 2012, and December 31, 2014. All patients who received first-line treatment at the participating facility were included. The QI scores were communicated to participating hospitals, and additional data about the reasons for non-adherence were collected. Results: In total, 297 hospitals participated, and the care provided to 15,163 cervical cancer patients was examined using 10 measurable QIs. The adherence rate ranged from 50.0% for ‘cystoscope or proctoscope for stage IVA’ to 98.8% for ‘chemotherapy using platinum for stage IVB’. Despite the variation in care, hospitals reported clinically valid reasons for more than half of the non-adherent cases. Clinically valid reasons accounted for 75%, 90.9%, 73.4%, 44.5%, and 88.1% of presented non-adherent cases respectively. Conclusion: Our study revealed variations in pattern of care as well as an adherence to standards-of-care across Japan. Further assessment of the causes of variation and non-adherence can help identify areas where improvements are needed in patient care.

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