Using Linked Lung Cancer Registry and Hospital Data for Guiding Health Service Improvement

Roder, D; You, H; Baker, D; Walton, R; McCaughan, B; Sranda, S; Currow, D

Using Linked Lung Cancer Registry and Hospital Data for Guiding Health Service Improvement

Roder, D You, H Baker, D Walton, R McCaughan, B Sranda, S Currow, D

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Publisher:: Australasian College of Health Service Management
Publication Type:: Journal Article
Citation:: Asia Pacific Journal of Health Management, 2016, 11, (1), pp. 65-75
Issue Date:: 2016-03-16

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Field	Value	Language
dc.contributor.author	Roder, D
dc.contributor.author	You, H
dc.contributor.author	Baker, D
dc.contributor.author	Walton, R
dc.contributor.author	McCaughan, B
dc.contributor.author	Sranda, S
dc.contributor.author	Currow, D https://orcid.org/0000-0003-1988-1250
dc.date.accessioned	2022-02-07T05:12:59Z
dc.date.available	2022-02-07T05:12:59Z
dc.date.issued	2016-03-16
dc.identifier.citation	Asia Pacific Journal of Health Management, 2016, 11, (1), pp. 65-75
dc.identifier.issn	1833-3818
dc.identifier.issn	2204-3136
dc.identifier.uri	http://hdl.handle.net/10453/154250
dc.description.abstract	<jats:p>Objective: To use linked NSW Cancer Registry and hospital lung cancer (LC) data for raising discussion points on how to improve outcomes. Design: Historical cohort – cases diagnosed in 2003-2007. Setting: New South Wales, Australia Outcome Measures: Relative odds (OR) of localised disease and resection of non-small cases (NSCLC) using multiple logistic regression. Comparisons of risk of NSCLC death using competing risk regression. Findings: (1) Older patients have fewer resections of localised NSCLC [adjusted OR 95% CLs; 80+Vs <60 years; 0.20 (0.14, 0.28)]. Cases with co-morbidity have fewer resections [adjusted OR, 0.74 (0.61, 0.90)] and have more conservative resections. Question: Is there the best balance between resection and avoiding surgery to accommodate frailty and co-morbidity? (2) Compared with public patients, the health insured: have higher odds of localised LC [adjusted OR, 1.23 (1.12, 1.35] and resection for localised NSCLC [adjusted OR, 2.08 (1.70, 2.54)]; are more likely to have lobectomies than wedge/segmental resections (p<0.001); and have a lower risk of LC death [adjusted SHR, 0.89 (0.85, 0.93)]. Question: Are there opportunities for improving publicpatient outcomes? (3) Patients born in non-English speaking countries have lower odds of localised disease [adjusted OR, 0.88 (0.79, 0.99)]. – Question: Could this difference be decreased by reducing cultural and language barriers? (4) Cancers of pulmonary lobes rather than the main bronchus pose lower risks of LC death. Question: Could outcomes for main bronchus cancers be improved by up-skilling or referral to higher-volume centres? (5) Greater extent of disease is strongly predictive of case fatality – Question: Could LC deaths be reduced by earlier treatment? (6) Use of lobectomies varies – Question: Could survival be increased through greater use of lobectomies for localised NSCLC? Conclusions: Linked cancer registry and hospital data can increase system-wide understanding of local health-service delivery and prompt discussion points on how to improve outcomes. Abbreviations: APDC – Australian Patient Data Collection; CHeReL – Centre for Health Record Linkage; EOD – Extent of Disease; LC – Lung Cancer; NSCLC – Non-Small Cell Cancers; NSWCR – New South Wales Cancer Registry; OR – Relative Odds; SEIFA – Socio-Economic Index for Areas; SES – Socio- Economic Status.</jats:p>
dc.language	en
dc.publisher	Australasian College of Health Service Management
dc.relation.ispartof	Asia Pacific Journal of Health Management
dc.relation.isbasedon	10.24083/apjhm.v11i1.247
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1117 Public Health and Health Services, 1503 Business and Management, 1605 Policy and Administration
dc.title	Using Linked Lung Cancer Registry and Hospital Data for Guiding Health Service Improvement
dc.type	Journal Article
utslib.citation.volume	11
utslib.for	1117 Public Health and Health Services
utslib.for	1503 Business and Management
utslib.for	1605 Policy and Administration
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	closed_access	*
dc.date.updated	2022-02-07T05:12:58Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	11
utslib.citation.issue	1

Abstract:

Objective: To use linked NSW Cancer Registry and hospital lung cancer (LC) data for raising discussion points on how to improve outcomes. Design: Historical cohort – cases diagnosed in 2003-2007. Setting: New South Wales, Australia Outcome Measures: Relative odds (OR) of localised disease and resection of non-small cases (NSCLC) using multiple logistic regression. Comparisons of risk of NSCLC death using competing risk regression. Findings: (1) Older patients have fewer resections of localised NSCLC [adjusted OR 95% CLs; 80+Vs <60 years; 0.20 (0.14, 0.28)]. Cases with co-morbidity have fewer resections [adjusted OR, 0.74 (0.61, 0.90)] and have more conservative resections. Question: Is there the best balance between resection and avoiding surgery to accommodate frailty and co-morbidity? (2) Compared with public patients, the health insured: have higher odds of localised LC [adjusted OR, 1.23 (1.12, 1.35] and resection for localised NSCLC [adjusted OR, 2.08 (1.70, 2.54)]; are more likely to have lobectomies than wedge/segmental resections (p<0.001); and have a lower risk of LC death [adjusted SHR, 0.89 (0.85, 0.93)]. Question: Are there opportunities for improving publicpatient outcomes? (3) Patients born in non-English speaking countries have lower odds of localised disease [adjusted OR, 0.88 (0.79, 0.99)]. – Question: Could this difference be decreased by reducing cultural and language barriers? (4) Cancers of pulmonary lobes rather than the main bronchus pose lower risks of LC death. Question: Could outcomes for main bronchus cancers be improved by up-skilling or referral to higher-volume centres? (5) Greater extent of disease is strongly predictive of case fatality – Question: Could LC deaths be reduced by earlier treatment? (6) Use of lobectomies varies – Question: Could survival be increased through greater use of lobectomies for localised NSCLC? Conclusions: Linked cancer registry and hospital data can increase system-wide understanding of local health-service delivery and prompt discussion points on how to improve outcomes. Abbreviations: APDC – Australian Patient Data Collection; CHeReL – Centre for Health Record Linkage; EOD – Extent of Disease; LC – Lung Cancer; NSCLC – Non-Small Cell Cancers; NSWCR – New South Wales Cancer Registry; OR – Relative Odds; SEIFA – Socio-Economic Index for Areas; SES – Socio- Economic Status.

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http://hdl.handle.net/10453/154250