Improving quality of cancer care at community hospitals: Impact of the National Cancer Institute Community Cancer Centers Program pilot

Michael Halpern, Pamela Spain, Debra J. Holden, Andrew Stewart, Erica J. McNamara, Greer Gay, Irene Prabhu Das, Steven Clauser

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: Patients with cancer treated at community hospitals may experience decreased quality of care compared with patients treated at higher-volume cancer hospitals. The National Cancer Institute Community Cancer Centers Program (NCCCP) pilot is designed to enhance research and improve cancer care at community hospitals. We assessed changes in quality of care among the 16 initial NCCCP sites versus 25 similar hospitals that did not participate in the NCCCP. Methods: We compared changes in concordance with five National Quality Forum-approved quality of care measures (three for breast cancer, two for colon cancer) for patients diagnosed from 2006 to 2007 (pre-NCCCP initiation) versus 2008 to 2010 (post-NCCCP initiation) at NCCCP and comparison-group hospitals. Data were collected using the Commission on Cancer Rapid Quality Reporting System. Analyses were performed using multivariate logistic regression. Results: Analyses included 18,608 patients with breast cancer and 7,031 patients with colon cancer. After NCCCP initiation, patient-level concordance rates for all five quality-of-care measures increased significantly among NCCCP and comparison-group hospitals. Increased quality of care among NCCCP sites was significantly greater than that among comparison-group hospitals for radiation therapy after breast-conserving surgery and hormonal therapy for women with hormone receptor-positive breast cancer. In multivariate regressions, increases in hormonal therapy among NCCCP-site patients were significantly greater than those among comparison-group hospitals. Conclusion: Both NCCCP and comparison-group hospitals showed improved quality of care; however, NCCCP sites had significantly greater improvements for a subset of measures. This greater increase may reflect the multidisciplinary focus of the NCCCP. Because many individuals receive cancer treatment at community hospitals, facilitating high-quality care in these environments must be a priority.

Original languageEnglish (US)
JournalJournal of Oncology Practice
Volume9
Issue number6
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

National Cancer Institute (U.S.)
Quality of Health Care
Community Hospital
Neoplasms
Colonic Neoplasms
Breast Neoplasms
carbonyl cyanide-4-nitro-2-chlorophenylhydrazone
High-Volume Hospitals
Cancer Care Facilities
Segmental Mastectomy
Radiotherapy
Therapeutics
Logistic Models
Hormones

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Health Policy

Cite this

Improving quality of cancer care at community hospitals : Impact of the National Cancer Institute Community Cancer Centers Program pilot. / Halpern, Michael; Spain, Pamela; Holden, Debra J.; Stewart, Andrew; McNamara, Erica J.; Gay, Greer; Das, Irene Prabhu; Clauser, Steven.

In: Journal of Oncology Practice, Vol. 9, No. 6, 2013.

Research output: Contribution to journalArticle

Halpern, Michael ; Spain, Pamela ; Holden, Debra J. ; Stewart, Andrew ; McNamara, Erica J. ; Gay, Greer ; Das, Irene Prabhu ; Clauser, Steven. / Improving quality of cancer care at community hospitals : Impact of the National Cancer Institute Community Cancer Centers Program pilot. In: Journal of Oncology Practice. 2013 ; Vol. 9, No. 6.
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N2 - Purpose: Patients with cancer treated at community hospitals may experience decreased quality of care compared with patients treated at higher-volume cancer hospitals. The National Cancer Institute Community Cancer Centers Program (NCCCP) pilot is designed to enhance research and improve cancer care at community hospitals. We assessed changes in quality of care among the 16 initial NCCCP sites versus 25 similar hospitals that did not participate in the NCCCP. Methods: We compared changes in concordance with five National Quality Forum-approved quality of care measures (three for breast cancer, two for colon cancer) for patients diagnosed from 2006 to 2007 (pre-NCCCP initiation) versus 2008 to 2010 (post-NCCCP initiation) at NCCCP and comparison-group hospitals. Data were collected using the Commission on Cancer Rapid Quality Reporting System. Analyses were performed using multivariate logistic regression. Results: Analyses included 18,608 patients with breast cancer and 7,031 patients with colon cancer. After NCCCP initiation, patient-level concordance rates for all five quality-of-care measures increased significantly among NCCCP and comparison-group hospitals. Increased quality of care among NCCCP sites was significantly greater than that among comparison-group hospitals for radiation therapy after breast-conserving surgery and hormonal therapy for women with hormone receptor-positive breast cancer. In multivariate regressions, increases in hormonal therapy among NCCCP-site patients were significantly greater than those among comparison-group hospitals. Conclusion: Both NCCCP and comparison-group hospitals showed improved quality of care; however, NCCCP sites had significantly greater improvements for a subset of measures. This greater increase may reflect the multidisciplinary focus of the NCCCP. Because many individuals receive cancer treatment at community hospitals, facilitating high-quality care in these environments must be a priority.

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