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Liu M, Guo R, Li J, Wang C, Yu L, Liu M. Process indicators outshine outcome measures: assessing hospital quality of care in breast cancer treatment in China. Sci Rep 2024; 14:19137. [PMID: 39160221 PMCID: PMC11333708 DOI: 10.1038/s41598-024-70474-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 08/16/2024] [Indexed: 08/21/2024] Open
Abstract
Reporting the results of quality indicators can narrow the gap in the quality of care between hospitals. While most studies rely on outcome indicators, they may not accurately measure the quality of care. Process indicators are not only strongly associated with treatment outcomes, but are also more sensitive to whether patients are treated accurately, enabling timely intervention. Our study aims to investigate whether process indicators provide a more reasonable assessment of hospital quality of care compared to outcome indicators. Data were sourced from the Specific Disease Medical Service Quality Management and Control System in China. A total of 113,942 patients with breast cancer treated in 298 hospitals between January 2019 and April 2023 were included in this retrospective study. The rankability of 11 process indicators was calculated and used as a weight to create a new composite indicator. The composite indicators and outcome measures were compared using the O/E ratio categories. Finally, in order to determine the impact of different years on the results, a sensitivity analysis was conducted using bootstrap sampling. The rankability ( ρ ) values of the eleven process indicators showed significant differences, with the highest ρ value for preoperative cytological or histological examination before surgery (0.919). The ρ value for the outcome indicator was 0.011. The rankability-weighting method yielded a comprehensive score ( ρ = 0.883). The comparison with categorical results of the outcome indicator has different performance classifications for 113 hospitals (37.92%) for composite scores and 140 (46.98%) for preoperative cytological or histological examinationbefore surgery. Process indicators are more suitable than outcome indicators for assessing the quality of breast cancer care in hospitals. Healthcare providers can use process indicators to identify specific areas for improvement, thereby driving continuous quality improvement efforts.
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Affiliation(s)
- Mengyang Liu
- Department of Biostatistics, School of Public Health, Harbin Medical University, No.157 Baojian Road, Harbin City, 150081, Heilongjiang Province, China
| | - Ruize Guo
- Department of Biostatistics, School of Public Health, Harbin Medical University, No.157 Baojian Road, Harbin City, 150081, Heilongjiang Province, China
| | - Jingkun Li
- Department of Biostatistics, School of Public Health, Harbin Medical University, No.157 Baojian Road, Harbin City, 150081, Heilongjiang Province, China
| | - Chao Wang
- Department of Biostatistics, School of Public Health, Harbin Medical University, No.157 Baojian Road, Harbin City, 150081, Heilongjiang Province, China
| | - Lei Yu
- Department of Biostatistics, School of Public Health, Harbin Medical University, No.157 Baojian Road, Harbin City, 150081, Heilongjiang Province, China
| | - Meina Liu
- Department of Biostatistics, School of Public Health, Harbin Medical University, No.157 Baojian Road, Harbin City, 150081, Heilongjiang Province, China.
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Kenyon CC, Bonafide CP. Hospital observed standard practice: Time to go back from whence hospitalists came? J Hosp Med 2022; 17:504-505. [PMID: 35621022 PMCID: PMC9197989 DOI: 10.1002/jhm.12845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Chén C Kenyon
- Center for Pediatric Clinical Effectiveness and the Division of General Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christopher P Bonafide
- Center for Pediatric Clinical Effectiveness and the Division of General Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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