Assurance de qualité pour le cancer rectal – phase 2 ...

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120 PROCARE – phase 2 KCE reports 81All patientsN = 7074Figure 32. Algorithm for QI 1217 (administrative database).Did patient receivechemotherapy ORradiotherapy ORsurgery ?TrueN = 6337Median time betweeninitial diagnosis andfirst treatment ?MissingN = 78QI = 14 daysFalseN = 659PROPORTION OF CSTAGE II-III PATIENTS THAT RECEIVED ASHORT COURSE OF NEOADJUVANT PELVIC RTMeasurement in prospective PROCARE database (Figure 33)Stage II and III RC patients are selected using the variables ‘SPR_V147’ and ‘PT_V106’for the cStage. In this group of patients, those receiving surgery are selected usingvariable ‘AD_V111’. Within this group of patients, patients receiving preoperativeradiotherapy are selected using variable ‘RD_V101’. Patients receiving a short course ofradiotherapy (i.e. 5 fractions of 5 Gy) are selected using variables ‘RD_V106’ (numberof fractions) and ‘RD_V109’ (total dose).Measurement in coupled administrative databaseIn the nomenclature, several codes are available for radiotherapy (Table 70). However,it is impossible to identify the exact number of fractions and radiation dose with thesecodes (e.g. both 25 x 1.8 Gy and 13 x 3 Gy can be billed with nomenclature code444150 – 444161). Some hospitals bill the entire radiotherapy regimen once (i.e. on thepatient level, the nomenclature code was found only once in the HIC database), otherhospitals bill every fraction separately (i.e. on the patient level, the nomenclature codewas found several times in the HIC database) (Table 81). Above this, the exact radiationdose cannot be retrieved from nomenclature codes. Therefore, the identification of ashort course of RT through nomenclature codes is impossible.In ICD-9-CM, two codes were identified for radiotherapy, again without specification ofdose and fractions (Table 71).
KCE Reports 81 PROCARE – phase 2 121Figure 33. Algorithm for QI 1221 & 1222 (prospective database).All patientsNeoadjuvant radiotherapyN=1071N=377c-Stage II-IIIN=517Stage?Surgery?SurgeryN=516Type of courseof neoadjuvant pelvicradiotherapy?SHORT COURSEN=26 6,18%LONG COURSENeoadjuvantradiotherapy?N=220 52,26%No surgeryN=1OTHER COURSEN=56c-Stage 0-I-IVN=219Course: NOT KNOWNN=75c-Stage UnknownN=335No neoadjuvant radiotherapyN=119Neoadjuvant radiotherapy? = MISSINGN=20Table 81. Number of bills with nomenclature code 444150 – 444161 forcStage II-III patients (neoadjuvant radiotherapy).Number of bills forN cStage II-III patientsneoadjuvant radiotherapy1 952 18 19 110 311 1012 313 2314 117 219 220 221 122 123 224 2025 8526 127 128 630 1
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