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Assessment of Pancreatic Cancer Care in the United States

Outcomes for pancreatic cancer patients vary considerably among hospitals. Factors responsible for this variability have been difficult to identify because valid indicators of high-quality care for pancreatic cancer patients are not available. Bilimoria et al. (p. 848 ) identified potential quality indicators, which were ranked as valid or not valid by a panel of experts. The valid indicators were used to assess patient- and hospital-level compliance and to develop a composite measure of adherence among hospitals in the United States. A total of 43 of the 50 potential quality indicators identified were rated as valid. These assessed structural factors (including case volume requirements, surgeon certification, and availability of consulting physicians and services), clinical processes of care, treatment appropriateness, efficiency, and outcomes. Hospital-level adherence with the valid indicators ranged from 7% to 100%. Most hospitals were adherent with fewer than half of the 10 indicators used to develop the composite measure of adherence. The authors suggest that hospitals can use these indicators to evaluate care and identify areas for improvement.