Skip to main content
Top
Published in: Health Research Policy and Systems 1/2012

Open Access 01-12-2012 | Research

A team approach to improving colorectal cancer services using administrative health data

Authors: Geoffrey Porter, Robin Urquhart, Jingyu Bu, Cynthia Kendell, Maureen MacIntyre, Ron Dewar, George Kephart, Yukiko Asada, Eva Grunfeld

Published in: Health Research Policy and Systems | Issue 1/2012

Login to get access

Abstract

Background

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Canada and accounts for 11.9% of all cancer-related mortality. Fortunately, previous studies have provided evidence of improved outcomes from access to timely and appropriate health services along the disease trajectory in CRC. As a result, the CIHR/CCNS Team in Access to Colorectal Cancer Services in Nova Scotia (Team ACCESS) was created to build colorectal cancer (CRC) research capacity in Nova Scotia (NS) and to study access to and quality of CRC services along the entire continuum of cancer care.

Objectives

The objectives of this paper are to: 1) provide a detailed description of the methodologies employed across the various studies being conducted by Team ACCESS; 2) demonstrate how administrative health data can be used to evaluate access and quality in CRC services; and 3) provide an example of an interdisciplinary team approach to addressing health service delivery issues.

Methods

All patients diagnosed with CRC in NS between 2001 and 2005 were identified through the Nova Scotia Cancer Registry (NSCR) and staged using the Collaborative Stage Data Collection System. Using administrative databases that were linked at the patient level, Team ACCESS created a retrospective longitudinal cohort with comprehensive demographic, clinical, and healthcare utilization data. These data were used to examine access to and quality of CRC services in NS, as well as factors affecting access to and quality of care, at various transition points along the continuum of care. Team ACCESS has also implemented integrated knowledge translation strategies targeting policy- and decision- makers.

Discussion

The development of Team ACCESS represents a unique approach to CRC research. We anticipate that the skills, tools, and knowledge generated from our work will also advance the study of other cancer disease sites in NS. Given the increasing prevalence of cancer, and with national and provincial funding agencies promoting collaborative research through increased funding for research team development, the work carried out by Team ACCESS is important in the Canadian context and exemplifies how a team approach is essential to comprehensively addressing issues surrounding not only cancer, but other chronic diseases in Canada.
Appendix
Available only for authorised users
Literature
1.
go back to reference Canadian Cancer Society: Canadian Cancer Statistics 2011. 2011, Canadian Cancer Society: Canadian Cancer Statistics 2011. 2011,
2.
go back to reference Canadian Cancer Society: Canadian Cancer Statistics 2009. 2009, Toronto, ON Canadian Cancer Society: Canadian Cancer Statistics 2009. 2009, Toronto, ON
3.
go back to reference Hershman DL, Wang X, McBride R, Jacobson JS, Grann VR, Neugut A: Delay in initiating adjuvant radiotherapy following breast conservation surgery and its impact on survival. Int J Radiat Oncol Biol Phys. 2006, 65 (5): 1353-1360. 10.1016/j.ijrobp.2006.03.048.CrossRefPubMed Hershman DL, Wang X, McBride R, Jacobson JS, Grann VR, Neugut A: Delay in initiating adjuvant radiotherapy following breast conservation surgery and its impact on survival. Int J Radiat Oncol Biol Phys. 2006, 65 (5): 1353-1360. 10.1016/j.ijrobp.2006.03.048.CrossRefPubMed
4.
go back to reference Berrino F, De Angelis R, Sant M, Rosso S, Lasota MB, Coebergh JB: Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995-99: results of the EUROCARE-4 study. Lancet Oncol. 2007, 8 (9): 773-783. 10.1016/S1470-2045(07)70245-0.CrossRefPubMed Berrino F, De Angelis R, Sant M, Rosso S, Lasota MB, Coebergh JB: Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995-99: results of the EUROCARE-4 study. Lancet Oncol. 2007, 8 (9): 773-783. 10.1016/S1470-2045(07)70245-0.CrossRefPubMed
5.
go back to reference Strengthening the quality of cancer services in Ontario. Edited by: Sullivan T, Evans W, Angus H, Hudson A. 2003, Ottawa: CHA Press Strengthening the quality of cancer services in Ontario. Edited by: Sullivan T, Evans W, Angus H, Hudson A. 2003, Ottawa: CHA Press
6.
go back to reference Collaborative Staging Task Force of the American Joint Committee on Cancer: Collaborative Staging Manual and Coding Instructions, version 01.04.00. 2007, Jointly published by American Joint Committee on Cancer (Chicago, IL) and U.S. Department of Health and Human Services (Bethesda, MD), [http://www.cancerstaging.org/cstage/manuals.html] Collaborative Staging Task Force of the American Joint Committee on Cancer: Collaborative Staging Manual and Coding Instructions, version 01.04.00. 2007, Jointly published by American Joint Committee on Cancer (Chicago, IL) and U.S. Department of Health and Human Services (Bethesda, MD), [http://​www.​cancerstaging.​org/​cstage/​manuals.​html]
7.
go back to reference NIH Consensus Conference: Adjuvant therapy for patients with colon and rectal cancer. JAMA. 1990, 264 (11): 1444-1450.CrossRef NIH Consensus Conference: Adjuvant therapy for patients with colon and rectal cancer. JAMA. 1990, 264 (11): 1444-1450.CrossRef
8.
go back to reference Urquhart R, Grunfeld E, Porter GA: Synoptic reporting and the quality of cancer care: a review of evidence and Canadian initiatives. OE. 2009, 8 (1): 28-31. Urquhart R, Grunfeld E, Porter GA: Synoptic reporting and the quality of cancer care: a review of evidence and Canadian initiatives. OE. 2009, 8 (1): 28-31.
9.
go back to reference American Joint Committee on Cancer: AJCC Cancer Staging Handbook from the AJCC Cancer Staging Manual, 6th ed. 2002, New York, NY: Springer American Joint Committee on Cancer: AJCC Cancer Staging Handbook from the AJCC Cancer Staging Manual, 6th ed. 2002, New York, NY: Springer
10.
go back to reference Phillips JL, Gress DM: Comparison of registrar collaborative staging and physician AJCC staging using data submitted to the National Cancer Data Base. J Registry Management. 2008, 35 (1): 4-11. Phillips JL, Gress DM: Comparison of registrar collaborative staging and physician AJCC staging using data submitted to the National Cancer Data Base. J Registry Management. 2008, 35 (1): 4-11.
14.
go back to reference O'Donnell O, van Doorslaer E, Wagstaff A, Lindelow M: Analyzing health equity using household survey data: A guide to techniques and their implementation. 2008, Washington, DC: The World Bank O'Donnell O, van Doorslaer E, Wagstaff A, Lindelow M: Analyzing health equity using household survey data: A guide to techniques and their implementation. 2008, Washington, DC: The World Bank
15.
go back to reference Hoffmaster B: What does vulnerability mean?. Hastings Cent Rep. 2006, 36 (2): 38-45. 10.1353/hcr.2006.0024.CrossRefPubMed Hoffmaster B: What does vulnerability mean?. Hastings Cent Rep. 2006, 36 (2): 38-45. 10.1353/hcr.2006.0024.CrossRefPubMed
16.
go back to reference Urquhart R, Grunfeld E: Measuring the quality of care provided to patients with colorectal cancer: the potential of quality indicators. OE. 2009, 8 (4): 6-10. Urquhart R, Grunfeld E: Measuring the quality of care provided to patients with colorectal cancer: the potential of quality indicators. OE. 2009, 8 (4): 6-10.
17.
go back to reference Elixhauser A, Steiner C, Harris DR, Coffey RM: Comorbidity measures for use with administrative data. Med Care. 1998, 36 (1): 8-27. 10.1097/00005650-199801000-00004.CrossRefPubMed Elixhauser A, Steiner C, Harris DR, Coffey RM: Comorbidity measures for use with administrative data. Med Care. 1998, 36 (1): 8-27. 10.1097/00005650-199801000-00004.CrossRefPubMed
18.
go back to reference Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC: Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005, 43 (11): 1130-1139. 10.1097/01.mlr.0000182534.19832.83.CrossRefPubMed Quan H, Sundararajan V, Halfon P, Fong A, Burnand B, Luthi JC: Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care. 2005, 43 (11): 1130-1139. 10.1097/01.mlr.0000182534.19832.83.CrossRefPubMed
19.
go back to reference Townsend P: Deprivation. J Soc Policy. 1987, 16 (2): 125-146. 10.1017/S0047279400020341.CrossRef Townsend P: Deprivation. J Soc Policy. 1987, 16 (2): 125-146. 10.1017/S0047279400020341.CrossRef
20.
go back to reference Pampalon R, Raymond G: A deprivation index for health and welfare planning in Quebec. Chronic Dis Can. 2000, 21 (3): 104-113.PubMed Pampalon R, Raymond G: A deprivation index for health and welfare planning in Quebec. Chronic Dis Can. 2000, 21 (3): 104-113.PubMed
21.
go back to reference Census of Canada: Postal Code Conversion File, PCCF+ Version 4J, September 2006 Postal Codes, 2001[2007]. Ottawa, ON Census of Canada: Postal Code Conversion File, PCCF+ Version 4J, September 2006 Postal Codes, 2001[2007]. Ottawa, ON
23.
go back to reference McNiven C, Puderer H, Janes D: Census Metropolitan Area and Census Agglomeration Influenced Zones (MIZ): A Description of the Methodology. 2000, Geography Division, Statistics Canada McNiven C, Puderer H, Janes D: Census Metropolitan Area and Census Agglomeration Influenced Zones (MIZ): A Description of the Methodology. 2000, Geography Division, Statistics Canada
24.
go back to reference Rayson D, Urquhart R, Colwell B, Grunfeld E: Limitations of chemotherapy data in administrative health databases: implications for measuring and improving quality of colorectal cancer care [abstract]. Can J Gastroent. 2010, 24: A193- Rayson D, Urquhart R, Colwell B, Grunfeld E: Limitations of chemotherapy data in administrative health databases: implications for measuring and improving quality of colorectal cancer care [abstract]. Can J Gastroent. 2010, 24: A193-
Metadata
Title
A team approach to improving colorectal cancer services using administrative health data
Authors
Geoffrey Porter
Robin Urquhart
Jingyu Bu
Cynthia Kendell
Maureen MacIntyre
Ron Dewar
George Kephart
Yukiko Asada
Eva Grunfeld
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Health Research Policy and Systems / Issue 1/2012
Electronic ISSN: 1478-4505
DOI
https://doi.org/10.1186/1478-4505-10-4

Other articles of this Issue 1/2012

Health Research Policy and Systems 1/2012 Go to the issue