Management
Enhancing Data Systems to Improve the Quality of Cancer Care
The National Cancer Policy Board (board) concluded in its April 1999 re- port, Ensuring Quality Cancer Care, that based on the best available evidence, some individuals with cancer do not receive care known to be effective for their condition. The magnitude of the problem is not known, but the board believes it is substantial (IOM 1999a). Why do we know so little about the nature and extent of care-related problems that affect so many Americans? In part, the lack of knowledge is a result of the fragmented nature of health care in the United States, with no central point of accountability. There are also more technical reasons, for example, an absence until recently of valid indicators of the quality of care, and the lack of comprehensive data systems with which to measure quality. Data systems are the backbone of efforts to improve the quality of health care. Performance data can provide the impetus for providers, health plans, and systems of care to change. Experience suggests that quality within health systems can improve when organizations measure and monitor performance, en- courage change through incentive systems and education, and hold providers accountable to the quality expectations of purchasers and consumers. Data systems can also help gauge the status of cancer care across the nation, alerting political, professional, and advocacy leaders to the need for action. An active health services research community furthers quality improvement by using data systems to determine correlates of quality cancer care and to elucidate the reasons for poor quality care.
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