Breast Cancer, Bronchial Cancer, Cervix Cancer, CNS Tumor, Colorectal Cancer, Endometrial Cancer, Head and Neck Tumor, Ovarian Cancer, Pancreatic Cancer, Prostate Cancer
Conditions
Keywords
quality of treatment, institution of treatment, certification, cancer centres, quality of care, treatment outcome, health services research
Brief summary
Assessment of the effectiveness of care in certified cancer centres for eight cancer entities via a retrospective cohort study based on secondary data from statutory health insurance funds and population-based clinical cancer registries.
Detailed description
Cancer constitutes the second most frequent cause of death in Germany. To maintain a high quality of treatment, the national cancer plan aims at a unified certification of cancer centres. The project Wirksamkeit der Versorgung in onkologischen Zentren (WiZen) investigates effects of treatments in certified cancer centres across large populations and different cancer entities in comparison to hospitals that do not hold a certificate. WiZen is a retrospective comparative cohort study that analyzes incident cases of eight types of cancer diagnosed within 2009-2017 based on nationwide health insurance data provided by WIdO (the AOK research institute) and data from regional clinical cancer registries (CCR) for the period 2006-2017. These eight types of cancer are colorectal cancer, pancreatic cancer, breast cancer, gynecologic tumors, lung cancer, prostate cancer, head and neck tumors and neuro-oncological tumors.
Interventions
OTHEROncological certification
Oncological certification encompasses a variety of criteria such as treatment according to the clinical guidelines, staffing, technical infrastructure, minimum caseloads, and multidisciplinary care.
Sponsors
Tumorzentrum Regensburg, Institut für Qualitätssicherung und Versorgungsforschung, Universität Regensburg
Arbeitsgemeinschaft Deutscher Tumorzenten e.V., ADT
Wissenschaftliches Institut der AOK (WIdO)
Technische Universität Dresden
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* first hospitalization due to diagnosis of colorectal cancer, pancreatic cancer, breast cancer, gynecologic tumors, lung cancer, prostate cancer, head and neck tumors, or neuro-oncological tumors 2009-2017 \[WIdO\] * hospitalization due to primary diagnosis of colorectal cancer, pancreatic cancer, breast cancer, gynecologic tumors, lung cancer, prostate cancer, head and neck tumors, or neuro-oncological tumors 2006-2017 \[CCR\]
Exclusion criteria
* prevalent diagnosis of colorectal cancer, pancreatic cancer, breast cancer, gynecologic tumors, lung cancer, prostate cancer, head and neck tumors, or neuro-oncological tumors 2006-2017 * exception: outpatient cancer diagnosis up to 12 months prior to first hospitalization is not regarded as prevalent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall survival | first hospitalization (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]), up to 31/12/2017 | Survival after first hospitalization due to cancer |
| 1- and 5-year survival | first hospitalization (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]) with 1 or 5-year follow-up, respectively | 1- and 5-year survival after first hospitalization due to cancer |
| 30-day mortality | first hospitalization (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]) with 30 days follow-up | 30-day mortality after first hospitalization due to cancer |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Complications due to surgery | date of initial cancer surgery with entity-specific follow-up | Complications due to cancer surgery |
| Successive resection | second resection within three months of initial cancer surgery | Second resection due to cancer |
| Entity-specific outcomes defined by clinical experts | 2009-2017 [CCR] or 2006-2017 [WIdO] | 1. Fractions of entity-specific surgery techniques 2. For head-neck-tumours: aspiration pneumonia due to swallowing dysfunctions |
| Fraction of patients | 2009-2017 | Fraction of patients in certified centres and in non-certified hospitals over time |
| 2-, 3-, 4-year survival | first hospitalization (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]) with 2,3, or 4-year follow-up, respectively | 2-, 3-, 4-year survival after first hospitalization due to cancer |
| Differences in patient characteristics | 2009-2017 [CCR] or 2006-2017 [WIdO] | Differences in demographic characteristics, disease severity and risk factors across certified centres/non-certified hospitals |
| Pathways of treatment | 2009-2017 | Patient's treatment pathways among general practitioners, specialists, and hospitals w.r.t. certification |
| Severity Levels in insurance data | 2009-2017 | Deduction of cancer severity levels through linkage of health insurance and cancer registry data |
| Regional differences | 2009-2017 | Differences across outcomes in different counties or federal states |
| Recurrence-free survival | cancer diagnosis (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]), up to 31/12/2017 | Recurrence-free survival after cancer diagnosis |
| Cumulative recurrence rate | cancer diagnosis (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]), up to 31/12/2017 | Cumulative recurrence rate after cancer diagnosis |
Countries
Germany
Outcome results
None listed