Abstract
BackgroundSurvival rates are widely used to compare the quality of cancer care. However, the extent to which cancer survivors regain full physical or cognitive functioning is not captured by this statistic. To address this concern we introduce post-diagnosis employment as a supplemental measure of the quality of cancer care.MethodsThis study is based on individual level data from the Norwegian Cancer Registry (n = 46,720) linked with data on labor market outcomes and socioeconomic status from Statistics Norway. We study variation across Norwegian hospital catchment areas (n = 55) with respect to survival and employment five years after cancer diagnosis. To handle the selection problem, we exploit the fact that cancer patients in Norway (until 2001) have been allocated to local hospitals based on their place of residence.ResultsWe document substantial differences across catchment areas with respect to patients' post-diagnosis employment rates. Conventional quality indicators based on survival rates indicate smaller differences. The two sets of indicators are only moderately correlated.ConclusionsThis analysis shows that indicators based on survival and post-diagnosis employment may capture different parts of the health status distribution, and that using only one of them to capture quality of care may be insufficient.
Highlights
Survival rates are widely used to compare the quality of cancer care
While about 80 percent (50 percent) of patients diagnosed with breast cancer were alive five years after diagnosis, only 13 percent (5 percent) of lung cancer patients were
In our sample 43 percent of the cancer patients had a localized tumor on the date of diagnosis
Summary
Survival rates are widely used to compare the quality of cancer care. The extent to which cancer survivors regain full physical or cognitive functioning is not captured by this statistic. To address this concern we introduce post-diagnosis employment as a supplemental measure of the quality of cancer care. Evaluation of the use of these resources is important from both efficiency and equity perspectives. This requires relevant and reliable measures of quality of care. Survival rates may miss important aspects of the quality of care. Quality indicators for health institutions reflecting patients’ long-term health status should be considered
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