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Quality of Care Issues in Colorectal Cancer

Authors' Affiliation: Department of Surgery, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California

Requests for reprints: Michael Leonardi, Department of Surgery, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, CA 90095. Phone: 310-794-4315; Fax: 310-267-0369; E-mail: mjleonardi{at}mednet.ucla.edu.

Colorectal cancer is a common, detectable, and treatable malignancy. Given the aging of the population, the number of patients diagnosed with colorectal cancer will likely increase; thus, efforts to improve the quality and delivery of appropriate care to patients with colorectal cancer are needed. The overarching goal of this article is to summarize recent efforts to evaluate and improve the quality of colorectal cancer care through the use of selective referral, quality performance measures, and assessment of outcomes. First, we provide a framework for quality of care assessment, including a discussion of the structural, process, and outcome components of care for colorectal cancer. Second, we discuss the current level of assessment of colorectal cancer care quality, highlighting four potential targets for quality improvement: increased provider volume for colorectal cancer resection, process-based quality measures for colorectal cancer care (including measures specific to colorectal cancer surgery), data collection and feedback programs for colorectal cancer care, and evaluation of health-related quality of life in patients with colorectal cancer. Further research is needed to evaluate both the implementation and effectiveness of these quality improvement strategies for improving outcome in patients with colorectal cancer.

New Approaches to Assessing and Treating Early-Stage Colon and Rectal Cancers

Quality of Care Issues in Colorectal Cancer

Authors' Affiliation: Department of Surgery, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California

Requests for reprints: Michael Leonardi, Department of Surgery, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, CA 90095. Phone: 310-794-4315; Fax: 310-267-0369; E-mail: mjleonardi{at}mednet.ucla.edu.

Colorectal cancer is a common, detectable, and treatable malignancy. Given the aging of the population, the number of patients diagnosed with colorectal cancer will likely increase; thus, efforts to improve the quality and delivery of appropriate care to patients with colorectal cancer are needed. The overarching goal of this article is to summarize recent efforts to evaluate and improve the quality of colorectal cancer care through the use of selective referral, quality performance measures, and assessment of outcomes. First, we provide a framework for quality of care assessment, including a discussion of the structural, process, and outcome components of care for colorectal cancer. Second, we discuss the current level of assessment of colorectal cancer care quality, highlighting four potential targets for quality improvement: increased provider volume for colorectal cancer resection, process-based quality measures for colorectal cancer care (including measures specific to colorectal cancer surgery), data collection and feedback programs for colorectal cancer care, and evaluation of health-related quality of life in patients with colorectal cancer. Further research is needed to evaluate both the implementation and effectiveness of these quality improvement strategies for improving outcome in patients with colorectal cancer.