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Quality and Efficiency in Swedish Cancer Care – Regional comparisons 2011

This is the first report of regional comparisons for Quality and Efficiency in Swedish Cancer Care. The report compares the various counties in terms of medical outcomes, patient experience and waiting times.

Summary

This is the first time that open comparisons have been presented that reflect care quality for ten common forms of cancer in Sweden. The report compares the various counties in terms of medical outcomes, patient experience and waiting times.

Survival rates among cancer patients are increasing

The percentage of cancer deaths has declined over the past 40 years, while survival rates have risen. The relative five-year survival rate among men increased from just over 50 per cent in 1990–1994 to almost 70 per cent in 2005–2009. For women, the survival rate increased from 60 to 68 per cent.

Patients with breast cancer and malignant melanoma had the highest survival rates.
The relative five-year survival rate among breast cancer patients was 87 per cent in 2005–2009. The survival rate for malignant melanoma was 93 per cent among women and 86 per cent among men during the period.

Lung cancer claims more Swedish lives each year than any other form of the disease.
Relative survival rates are low but have increased, particularly the one-year rate, since the early 1990s. The relative five-year survival rate is approximately 15 per cent among women and 12 per cent among men.

No county consistently stands out in terms of survival rates for multiple types of cancer as well as for both sexes. However, lung cancer and bladder cancer show major variations between counties.

The frequency of multidisciplinary team meetings varies

Multidisciplinary team meetings are often important for assessing a patient’s medical needs and setting up an individual treatment plan. The report demonstrates that the number of new patients who receive such an assessment varies from 4 to 100 per cent between the different counties, as well as between the different forms of cancer. Multidisciplinary team meetings are not indicated or expedient prior to emergency surgery for colon cancer and in certain other situations.

Waiting times vary significantly

The report shows that waiting times vary significantly among counties and forms of cancer. For instance, the median waiting time from receipt of a referral until the initial appointment with a specialist ranged from 17 to 43 days.

A concerted effort has been made in recent years to shorten healthcare waiting times. The waiting times presented in this report cover a period when this effort was beginning but had not been fully implemented. The data can now be used for future comparisons.

Diagnostic methods are more effective in some areas

Assessment and diagnosis of cancer has improved in some areas. Here are a few examples:

  • The number of patients who underwent bone scintigraphy for low-risk localised prostate cancer decreased from 38 to 4.5 per cent in 2000–2009 (few such patients actually need the examination)
  • A total of 83 per cent of all kidney cancer patients had CT scans, which is very close to the clinical practice guidelines target
  • Almost all counties met the lung cancer guidelines that biopsies be performed for 99 per cent of patients

Some cancer care outcomes

Most indicators in the report reflect medical quality, such as the use of various treatment options, as well as postoperative outcomes and complications. Following are some examples:

  • The number of patients with medium to high-risk prostate cancer who received curative treatment increased from 48 per cent in 2000 to 68 per cent in 2009
  • Use of the sentinel node technique to identify breast cancer cases in which complete removal of lymph nodes from the armpit area is indicated rose to 80 percent in 2009
  • A total of 1.5 per cent of breast cancer cases were reoperated in 2009 due to bleeding, infection or other complications; the percentage has remained essentially unchanged in recent years
  • A total of 8.7 per cent of colon cancer cases and 10.8 per cent of rectal cancer cases were reoperated in 2007–2009

Open comparisons offer a snapshot

This report is descriptive in nature and strives to present a snapshot of current cancer care.

The dual purpose of the report is to provide supporting data for decision makers at various levels who are attempting to improve cancer care while offering the general public some insight into what publicly financed cancer care is accomplishing.

County outcomes for each of the indicators are shown in ranked diagrams, but no weighted ranking of the counties based on overall quality and efficiency is presented. The choice is intentional, given that no nationally confirmed method of weighting indicators has yet been devised. The outcomes should be interpreted in light of data quality and the other considerations discussed in connection with each indicator.

The report omits certain areas, including rehabilitation, nursing and psychosocial care, as well as patient experience of health and disease after treatment (patientreported outcome measures). Registers, other data sources and indicators need to be developed for these areas before they can be included in future comparisons.

Read the full Summary

Year: 2012
Article number: 2012-3-15
ISBN: 978-91-7164-784-9
Format: Bok
Pages: 128
Language: Engelska
Price (VAT included): 50 kr