Quality-of-care indicators for oesophageal cancer surgery: A review

Eur J Surg Oncol. 2010 Nov;36(11):1035-43. doi: 10.1016/j.ejso.2010.08.131. Epub 2010 Sep 16.

Abstract

Background: Quality-of-care indicators are measurable elements of practice performance that can assess the (change in) quality of the care provided. To date, the literature on quality-of-care indicators for oesophageal cancer surgery has not been reviewed.

Methods: We performed a review of the literature on quality-of-care indicators for oesophageal cancer surgery. The indicators were classified by their nature of care provision (structural, process, or outcome).

Results: One hundred thirty articles were included. For structural measures, most evidence was found for the inverse relationship between hospital or surgeon volume and post-operative mortality. Few articles described the required infrastructural and organisational elements for oesophageal cancer surgery. Regarding process measures, the most common indicators were determinants of patient selection for surgery. Other process indicators with considerable evidence were found (e.g., multidisciplinary team management), though the number of studies was small. For outcome indicators, the level of evidence for pathological outcome measures was strong. Data on post-operative complications as outcome indicators varied widely.

Conclusion: Since there is considerable variation in the evaluation of quality of care, the uniform use of well-defined quality-of-care indicators to measure and document practice performance holds the promise of improving outcome in patients who undergo oesophageal cancer surgery.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Chemotherapy, Adjuvant
  • Esophageal Neoplasms / diagnosis*
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy* / adverse effects
  • Esophagectomy* / methods
  • Esophagectomy* / standards
  • Esophagectomy* / statistics & numerical data
  • Evidence-Based Medicine
  • Humans
  • Length of Stay
  • Neck Dissection
  • Neoplasm Staging
  • Netherlands
  • Observer Variation
  • Outcome Assessment, Health Care
  • Outcome and Process Assessment, Health Care*
  • Patient Care Team
  • Patient Selection
  • Quality of Health Care*
  • Radiotherapy, Adjuvant
  • Risk Assessment
  • Risk Factors