Feasibility of evaluating quality cancer care using registry data and electronic health records: a population-based study

Objective. To evaluate the quality of patients care, a set of indicators of the standards of cancer care were defined. Design, Setting, Participants. We developed a set of indicators to assess the implementation in daily practice of recommendation produced by a regional network (Istituto Toscano Tumori). This set was tested in a retrospective study in the resident population of the Tuscany Region; the regional health system is organi2ed on 12 local health authorities which refer to three macro areas (Area Vasta). The study included incident colorectal, lung and breast cancer cases listed in 2004 for the Tuscan Cancer Registry, a population-based registry which collected tumor cases diagnosed in all residents in Tuscany. Electronic data from registry database were used to determine the compliance with each indicator for patients in 2004. To validate the results, an ad hoc clinical survey including the same geographical area for the year 2006 was performed. Intervention. None. Main Outcome Measures. The proportion of patients who fulfilled each of the indicators. Results. Our study showed the feasibility of the evaluation of the quality of cancer care using cancer registry populationbased data and major computerized information systems. The estimation of the selected indicators confirmed a good homogeneity among areas, and globally revealed a good intraregional performance. Conclusions. Further work is needed to develop specific quality measures, particularly about structural data and to continually revise indicators of quality of care. Data from a cancer registry, however, can be useful to evaluate quality of cancer care