The association between quality care and outcomes for a real-world population of Australian patients diagnosed with pancreatic cancer

Ashika D. Maharaj, Sue M. Evans, Liane J. Ioannou, Daniel Croagh, Arul Earnest, Jennifer F. Holland, Charles H.C. Pilgrim, Rachel E. Neale, David Goldstein, James G. Kench, Neil D. Merrett, Kate White, Elizabeth A. Burmeister, Peter M. Evans, Theresa M. Hayes, Nezor Houli, Brett Knowles, Trevor Leong, Mehrdad Nikfarjam, Jennifer PhilipMaddy Quinn, Jeremy Shapiro, Marty D. Smith, John B. Spillane, Rachel Wong, John R. Zalcberg

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)

Abstract

Background: This study: (i) assessed compliance with a consensus set of quality indicators (QIs) in pancreatic cancer (PC); and (ii) evaluated the association between compliance with these QIs and survival. Methods: Four years of data were collected for patients diagnosed with PC. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). A multivariable analysis tested the relationship between significant patient and hospital characteristics, patient cluster effects within hospitals and survival. Results: 1061 patients were eligible for this study. Significant association with improved survival were: (i) in the potentially resectable group having adjuvant chemotherapy administered following surgery or a reason documented (HR, 0.29; 95 CI, 0.19–0.46); (ii) in the locally advanced group included having chemotherapy ± chemoradiation, or a reason documented for not undergoing treatment (HR, 0.38; 95 CI, 0.25–0.58); and (iii) in the metastatic disease group included having documented performance status at presentation (HR, 0.65; 95 CI, 0.47–0.89), being seen by an oncologist in the absence of treatment (HR, 0.48; 95 CI, 0.31–0.77), and disease management discussed at a multidisciplinary team meeting (HR, 0.79; 95 CI, 0.64–0.96). Conclusion: Capture of a concise data set has enabled quality of care to be assessed.

Original languageEnglish
Pages (from-to)950-962
Number of pages13
JournalHPB
Volume24
Issue number6
DOIs
Publication statusPublished - Jun 2022

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