The process measures included four Surgical Care Improvement Project (SCIP) measures such as antibiotic administration, blood clot prophylaxis, and the use of beta blockers. He also compared results on patient experience surveys.
"We were interested in whether the results correlated," he says, acknowledging that he thought they would, with bigger, better-equipped cancer-designated hospitals scoring better on both counts.
The study also points to a critical need to develop better reporting of outcomes from acute care practices directly linked to treatments for cancer, which according to the Centers for Disease Control and Prevention affects 20.1 million living Americans. Cancer care spending is enormous, accounting for $1 in every $12 Medicare fee for service dollars.
No specific measures related to cancer care are currently required for hospitals that treat cancer patients, although that will change this fall when rules of the Patient Protection and Affordable Care Act require 11 Prospective Payment System-exempt hospitals to report a handful of measures.
Still, many of those measures also do not relate to cancer care but to adverse events like urinary tract infections.
What is needed, Bilimoria says, are measures that get to the heart of appropriate cancer care, such as "did (the cancer center and oncology team) deliver adjuvant therapy when it was indicated, did they stage the patient properly before surgery… and the question I get asked the most from my patients, did you get it all? Was there a negative margin?"