National Clinical Database Feedback Implementation for Quality Improvement of Cancer Treatment in Japan: from Good to Great Through Transparency

Overview

Journal Surg Today

Specialty General Surgery

Date 2015 Mar 24

PMID 25797948

Citations 66

Authors

Mitsukazu Gotoh

Hiroaki Miyata

Hideki Hashimoto

Go Wakabayashi

Hiroyuki Konno

Shuichi Miyakawa

Kenichi Sugihara

Masaki Mori

Susumu Satomi

Norihiro Kokudo

Tadashi Iwanaka

Affiliations

Soon will be listed here.

Abstract

The National Clinical Database (NCD) of Japan was established in April, 2010 with ten surgical subspecialty societies on the platform of the Japan Surgical Society. Registrations began in 2011 and over 4,000,000 cases from more than 4100 facilities were registered over a 3-year period. The gastroenterological section of the NCD collaborates with the American College of Surgeons' National Surgical Quality Improvement Program, which shares a similar goal of developing a standardized surgical database for surgical quality improvement, with similar variables for risk adjustment. Risk models of mortality for eight procedures; namely, esophagectomy, partial/total gastrectomy, right hemicolectomy, low anterior resection, hepatectomy, pancreaticoduodenectomy, and surgery for acute diffuse peritonitis, have been established, and feedback reports to participants will be implemented. The outcome measures of this study were 30-day mortality and operative mortality. In this review, we examine the eight risk models, compare the procedural outcomes, outline the feedback reporting, and discuss the future evolution of the NCD.

Citing Articles

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References

Werner R, Asch D . The unintended consequences of publicly reporting quality information. JAMA. 2005; 293(10):1239-44. DOI: 10.1001/jama.293.10.1239. View

Kobayashi H, Miyata H, Gotoh M, Baba H, Kimura W, Kitagawa Y . Risk model for right hemicolectomy based on 19,070 Japanese patients in the National Clinical Database. J Gastroenterol. 2013; 49(6):1047-55. DOI: 10.1007/s00535-013-0860-8. View

Hall B, Hamilton B, Richards K, Bilimoria K, Cohen M, Ko C . Does surgical quality improve in the American College of Surgeons National Surgical Quality Improvement Program: an evaluation of all participating hospitals. Ann Surg. 2009; 250(3):363-76. DOI: 10.1097/SLA.0b013e3181b4148f. View

Anazawa T, Miyata H, Gotoh M . Cancer registries in Japan: National Clinical Database and site-specific cancer registries. Int J Clin Oncol. 2014; 20(1):5-10. DOI: 10.1007/s10147-014-0757-4. View

Yasunaga H, Matsui H, Horiguchi H, Fushimi K, Matsuda S . [Application of the diagnosis procedure combination (DPC) data to clinical studies]. J UOEH. 2014; 36(3):191-7. DOI: 10.7888/juoeh.36.191. View

Kurita N, Miyata H, Gotoh M, Shimada M, Imura S, Kimura W . Risk Model for Distal Gastrectomy When Treating Gastric Cancer on the Basis of Data From 33,917 Japanese Patients Collected Using a Nationwide Web-based Data Entry System. Ann Surg. 2015; 262(2):295-303. DOI: 10.1097/SLA.0000000000001127. View

Yasunaga H, Hashimoto H, Horiguchi H, Miyata H, Matsuda S . Variation in cancer surgical outcomes associated with physician and nurse staffing: a retrospective observational study using the Japanese Diagnosis Procedure Combination Database. BMC Health Serv Res. 2012; 12:129. PMC: 3405470. DOI: 10.1186/1472-6963-12-129. View

Fung C, Lim Y, Mattke S, Damberg C, Shekelle P . Systematic review: the evidence that publishing patient care performance data improves quality of care. Ann Intern Med. 2008; 148(2):111-23. DOI: 10.7326/0003-4819-148-2-200801150-00006. View

Watanabe M, Miyata H, Gotoh M, Baba H, Kimura W, Tomita N . Total gastrectomy risk model: data from 20,011 Japanese patients in a nationwide internet-based database. Ann Surg. 2014; 260(6):1034-9. DOI: 10.1097/SLA.0000000000000781. View

10.

Birkmeyer J, Gust C, Dimick J, Birkmeyer N, Skinner J . Hospital quality and the cost of inpatient surgery in the United States. Ann Surg. 2011; 255(1):1-5. PMC: 3249383. DOI: 10.1097/SLA.0b013e3182402c17. View

11.

Kenjo A, Miyata H, Gotoh M, Kitagawa Y, Shimada M, Baba H . Risk stratification of 7,732 hepatectomy cases in 2011 from the National Clinical Database for Japan. J Am Coll Surg. 2014; 218(3):412-22. DOI: 10.1016/j.jamcollsurg.2013.11.007. View

12.

Kimura W, Miyata H, Gotoh M, Hirai I, Kenjo A, Kitagawa Y . A pancreaticoduodenectomy risk model derived from 8575 cases from a national single-race population (Japanese) using a web-based data entry system: the 30-day and in-hospital mortality rates for pancreaticoduodenectomy. Ann Surg. 2013; 259(4):773-80. DOI: 10.1097/SLA.0000000000000263. View

13.

Dahlke A, Chung J, Holl J, Ko C, Rajaram R, Modla L . Evaluation of initial participation in public reporting of American College of Surgeons NSQIP surgical outcomes on Medicare's Hospital Compare website. J Am Coll Surg. 2014; 218(3):374-80, 380.e1-5. PMC: 4324751. DOI: 10.1016/j.jamcollsurg.2013.11.022. View

14.

Takeuchi H, Miyata H, Gotoh M, Kitagawa Y, Baba H, Kimura W . A risk model for esophagectomy using data of 5354 patients included in a Japanese nationwide web-based database. Ann Surg. 2014; 260(2):259-66. DOI: 10.1097/SLA.0000000000000644. View

15.

Matsubara N, Miyata H, Gotoh M, Tomita N, Baba H, Kimura W . Mortality after common rectal surgery in Japan: a study on low anterior resection from a newly established nationwide large-scale clinical database. Dis Colon Rectum. 2014; 57(9):1075-81. DOI: 10.1097/DCR.0000000000000176. View

16.

Lee T . Eulogy for a quality measure. N Engl J Med. 2007; 357(12):1175-7. DOI: 10.1056/NEJMp078102. View

17.

Dindo D, Demartines N, Clavien P . Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004; 240(2):205-13. PMC: 1360123. DOI: 10.1097/01.sla.0000133083.54934.ae. View

18.

Birkmeyer N, Birkmeyer J . Strategies for improving surgical quality--should payers reward excellence or effort?. N Engl J Med. 2006; 354(8):864-70. DOI: 10.1056/NEJMsb053364. View

19.

Suzuki H, Gotoh M, Sugihara K, Kitagawa Y, Kimura W, Kondo S . Nationwide survey and establishment of a clinical database for gastrointestinal surgery in Japan: Targeting integration of a cancer registration system and improving the outcome of cancer treatment. Cancer Sci. 2010; 102(1):226-30. PMC: 11158537. DOI: 10.1111/j.1349-7006.2010.01749.x. View

20.

Miyata H, Gotoh M, Hashimoto H, Motomura N, Murakami A, Tomotaki A . Challenges and prospects of a clinical database linked to the board certification system. Surg Today. 2014; 44(11):1991-9. DOI: 10.1007/s00595-013-0802-3. View