Application of quality indicators in breast cancer care using linked national registry and administrative claims data

Abstract

6565 Background: The National Quality Forum (NQF) recently approved quality measures for cancer care. These are intended for application through cancer registries. Variably complete cancer registry data on outpatient care may limit application of these measures. Administrative claims matched to registries may provide more complete data. This study tested the ability to match claims with the National Cancer Data Base (NCDB) registry and to apply NQF breast cancer measures in a limited pilot in one region. Methods: Claims data from one regional payer in Western New York (WNY) were matched with registry data from the 3 WNY hospitals participating in the NCDB for 2001–2003. NQF measures for hormone therapy (HT), radiation (RT) with breast conserving surgery (BCS) and chemotherapy (CT) were applied independently using registry and claims data. Results: 480 women with this payer had claims for breast cancer surgery at the NCDB hospitals and 439 (91%) matched NCDB based on birth date, date of treatment and reporting hospital. Among these, 17 had duplicate or incomplete records. Among 422 analytic cases the median age was 54 and stage was 0 –9%; I –49%; II –33%; III –7%; IV –2%. Claims identified CT, HT and RT in substantially more cases than identified by the registry ( Table 1 ). Claims also provided information not collected by registry including specific drugs used and duration of therapy. Conclusions: Matching NCDB with payer claims is possible based on limited identifiers, and quality measures can be applied using claims. Registry data in WNY NCDB hospitals did not capture some RT, HT and CT identified by claims. Though in aggregate the registries in WNY shows substantially lower treatment rates than national NCDB averages, this study demonstrates that claims enhance registry data. Linkage of claims with NCDB may be a robust tool to apply quality measures of cancer care. No significant financial relationships to disclose. [Table: see text]