Abstract
Long-term survival rates of cancer patients represent important information for policymakers and providers, but analyses from voluntary cancer registries in Japan may not reflect the overall situation. In 2003, the Diagnosis Procedure Combination Per-Diem Payment System (DPC/PDPS) for hospital reimbursement was introduced in Japan; more than half of Japan’s acute care beds are currently covered under this system. Administrative data produced under the DPC system include claims data and clinical summaries for each admission. Due to the large amount of data spanning multiple institutions, this database may have applications in providing a more general and inclusive overview of healthcare. Here, we investigate the use of administrative data for analyses of long-term survival in cancer patients. We analyzed postoperative survival in 7,064 patients with primary non-small cell lung cancer admitted to 102 hospitals between April 2008 and March 2013 using DPC data. Survival was defined at the last date of examination or discharge within the study period, and the event was mortality during the same period. Overall survival rates for different cancer stages were calculated using the Kaplan-Meier method. Additionally, survival rates of cancer patients at clinical stage IA were compared between low- and high-volume hospitals using the Log-rank test. Postoperative 5-year survival for patients at stage IA was 85.8% (95% CI = 78.6%–93.0%). High-volume hospitals had higher survival rates than hospitals with lower volume. Our findings using large-scale administrative data were similar to previous clinical registry reports, showing potential applications as a new method in analyzing up-to-date healthcare information.
Highlights
Survival rates of cancer patients are a major concern for both patients and physicians, and are often referred to when determining patient prognoses and care strategies.Cancer registries at the national level support the study of cancer etiology and outcomes, including analyses of survival rates (McLaughlin et al 2010)
There exists a population-based cancer registry; a hospital-based cancer registry; and “organ-based” registries administrated by various medical associations and organizations, such as the Japanese Joint Committee for Lung Cancer Registration
Data In this retrospective cohort study, we analyzed the postoperative survival of non-small cell lung cancer patients using administrative data
Summary
Survival rates of cancer patients are a major concern for both patients and physicians, and are often referred to when determining patient prognoses and care strategies.Cancer registries at the national level support the study of cancer etiology and outcomes, including analyses of survival rates (McLaughlin et al 2010). There exists a population-based cancer registry (http://www.jacr.info/); a hospital-based cancer registry (http://ncc.ctr-info.com/); and “organ-based” registries administrated by various medical associations and organizations, such as the Japanese Joint Committee for Lung Cancer Registration (http://haigan-touroku.jp/). These registries possess several shortcomings: for example, the population-based cancer registry has been reported to contain omissions of cases, and survival analyses have not been conducted (Sobue et al 2007). Registries managed by medical associations generally include only voluntary participations All of these registry databases do not adhere to a single format, and there is no framework that allows for their simple integration (Sobue et al 2007; Hirata et al 2012). Medical associations conduct and report highly detailed surveys, but tend to struggle with low respondent rates (Sawabata et al 2011)
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