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

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

doi:10.1186/1478-4505-10-4

Abstract

BackgroundColorectal 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.ObjectivesThe 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.MethodsAll 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.DiscussionThe 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.

Highlights

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Canada and accounts for 11.9% of all cancer-related mortality
The development of Team ACCESS represents a unique approach to colorectal cancer (CRC) research
We anticipate that the skills, tools, and knowledge generated from our work will advance the study of other cancer disease sites in Nova Scotia (NS)

Summary

Introduction

Colorectal cancer (CRC) is the third most commonly diagnosed cancer in Canada and accounts for 11.9% of all cancer-related mortality. Team ACCESS possesses expertise in health services research, epidemiology, biostatistics, population health, health administration, primary care, psychiatry, pediatrics, pathology, and surgical, medical, and radiation oncology Through this unprecedented collaborative research effort in NS, Team ACCESS has sought to improve the capacity to examine access to and quality of CRC services at transition points across the entire continuum of cancer care (i.e., presentation of signs/symptoms, diagnosis, surgery, systemic and radiation therapy, follow-up care, and advanced disease/palliative care). Such transitions may be susceptible to problems of access and quality since they often require patients to move across health care sectors as part of a complex and fragmented delivery system [5]

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