Quality of surgical care of pancreatic cancer in a single payer North American health care
نویسندگان
چکیده
Quality of surgical care of Canadian patients with pancreatic Introduction: cancer (PC) is inadequately known. Primary aim of this study was to analyze the quality of care received by patients who underwent resections of PC in Nova Scotia over a 10-year period (2001-2011). All patients with PC (n. 1094) were identified using provincial cancer Methods: registries and only adult patients with resectable disease were included in the study (n. 109). Well established disease-specific quality indicators (QIs) were used as references. The proportion of patients who met those QIs was calculated. The average and 95 % confidence intervals of QIs were compared between patients treated in Nova Scotia and published references. Surgical therapy was performed in 9.9 % of patients. Perioperative Results: morbidity and mortality occurred in 25 % and 5 % of patients respectively. Overall survival was 57 % at 1 year, 18 % at 3 year and 9 % at 5 year. R1 resections occurred in 38 % of patients. When compared to published quality measures, patients in Nova Scotia had similar outcomes except for an inferior number of lymph nodes found in the surgical specimens (9 vs. 19; P<0.05). On the other hand, a significant proportion of patients did not fully meet several QIs linked to preoperative, surgical pathology and postoperative care. In Nova Scotia, the proportion of patients who underwent Conclusions: surgery for PC was lower than expected. Although perioperative morbidity, mortality and survival rates were comparable to published references, many did not meet established standard QIs. 1 1 1 1 1
منابع مشابه
Effect of Acceptance and Commitment Therapy (ACT) on Quality of Life, Mental Health and Self-care Behavior in Breast Cancer Patients
Introduction: Breast cancer is the most common cancer among women which leaves a profound impact on psychosocial health, and quality of life in women, therefore the aim of this study was investigation the effectiveness of acceptance and commitment therapy (ACT) on Quality of life, mental health and self-care behavior in breast cancer patients. Methods: In a pretest-posttest experimental desi...
متن کاملSingle-payer national health insurance. Physicians' views.
BACKGROUND Forty-one million Americans have no health insurance and, despite the growth of managed care, medical costs are again increasing rapidly. One proposed solution is a single-payer health care financing system with universal coverage. Yet, physicians' views of such a system have not been well studied. METHODS We surveyed a random sample of physicians (from the American Medical Associa...
متن کاملUnderstanding Contextual Factors in Cost, Quality and Priority Setting Decisions in Health; Comment on “Contextual Factors Influencing Cost and Quality Decisions in Health and Care: A Structured Evidence Review and Narrative Synthesis”
There is growing recognition in the academic literature that critical decisions concerning resource allocation and resource management in health and care are influenced by a range of contextual factors. In their paper in this journal, Williams et al define these ‘decisions of value’ as being characterized by a significant and demonstrable impact on quality and resources in health and care. ‘Dec...
متن کاملAn international comparison of cancer survival: metropolitan Toronto, Ontario, and Honolulu, Hawaii.
OBJECTIVES Comparisons of cancer survival in Canadian and US metropolitan areas have shown consistent Canadian advantages. This study tests a health insurance hypothesis by comparing cancer survival in Toronto, Ontario, and Honolulu, Hawaii. METHODS Ontario and Hawaii registries provided a total of 9190 and 2895 cancer cases (breast and prostate, 1986-1990, followed until 1996). Socioeconomic...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره شماره
صفحات -
تاریخ انتشار 2016