|Short description of Indicator
||30-day and 90-day post-surgery mortality
|Rationale for measurement
||The intent of this QBP indicator is to monitor the quality of cancer surgeries by measuring the rate of mortality within 30 and 90 days of the original lung cancer resection.
|Evidence/references for rationale
|Calculations for the indicator
(Number of QBP lung cancer surgery patients who died within 30 days after cancer surgery /Total number of QBP lung cancer surgeries) * 100 = Percentage of patients who died within 30 days of lung cancer surgery.
(Number of QBP lung cancer surgery patients who died within 90 days after cancer surgery /Total number of QBP lung cancer surgeries) * 100 = Percentage of patients who died within 90 days of lung cancer surgery.
|Standardized Rate Calculation
||Canadian Institute for Health Information (CIHI) - Discharge Abstracts Database (DAD) Canadian Institute for Health Information (CIHI) - National Ambulatory Care Reporting System (NACRS)
||CY2014 - CY2017
- By Province
- By Calendar Year
Total number of unique patients who had lung cancer surgical resection CY2014 – CY2017
- Select cohort of in-scope cases based on QBP methodology for the discharge date range April 1 2014 to March 31 2018 - an in-scope case must satisfy both conditions below:
a) Have an In-scope CCI procedure coded as the Primary Intervention on DAD/NACRS records. A list of procedure codes is shown in the Quality-Based Procedures Clinical Handbook for Cancer Surgery, Ministry of Health and Long-Term Care, August 2018.
b) Have an In-scope ICD-10-CA diagnosis coded as the Main Diagnosis on DAD/NACRS records. A list of diagnosis codes is displayed in the Quality-Based Procedures Clinical Handbook for Cancer Surgery, Ministry of Health and Long-Term Care, August 2018.
- Apply QBP exclusions.
- Assign resection date as a date when resection took place.
- Cases with non-unique OHIP number (OHIP number in 1, 8, 9, 0)
- Cases younger than 18 years at the time of surgical intervention
- Records where the main intervention is missing
- Out-of-province records (non-Ontario health card numbers)
- Non-OHIP cases (responsibility of payment = 1)
- Interventions flagged as Cancelled, Abandoned and Out of Hospital
- Outpatient Records (NACRS) for Colorectal and Prostate disease sites.
Inclusions: Small non-QBP hospitals are included in the denominator
Number of unique patients who died within 30 and 90 days after the lung cancer surgery
Subset of denominator:
- Date of death was determined by linking the denominator cohort (on health card number) to the Registered Persons Database (RPDB).
- To decide if the patient died within 30 & 90 days after surgery, the number of days between the resection date and date of death were determined.
- Complete fiscal year data are delayed due to hospital reporting timelines.
- Data of death in RPDB is delayed by around 3 months.
- Records with discharge date (CIHI-DAD & NACRS) between from January 01 2014 to Dec 31 2017 are selected.
- CCO’s QBP 18/19 Index Methodology.
- The case will be considered in-scope only if it has both an in-scope procedure and an in-scope diagnosis codes on the record.
- The in-scope procedure and diagnosis codes must be identified as Primary Intervention and Main Diagnosis, respectively.
- Cause of death is not considered.
|Data availability & limitations
||Data is obtained from CIHI-DAD and CIHI-NACRS where the discharge date range was January 1 2014 to December 31 2017.