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Current Oncology
Volume 27
Issue 1
10.3747/co.27.5349
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Article

Can Concordance between Actual Care Received and a Pathway Map Be Measured on a Population Level in Ontario? A Pilot Study

by
K. Forster
1,
K. Tsang
1,
S. Li
1,
L. Ieraci
1,
P. Murray
1,
K.J. Woltman
1,
D. Chmelnitsky
1,
C.M.B. Holloway
1,2 and
E.D. Kennedy
1,3,4,*
1
Ontario Health (Cancer Care Ontario), University of Toronto, Toronto, ON, Canada
2
Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
3
Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
4
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2020, 27(1), 27-33; https://doi.org/10.3747/co.27.5349
Submission received: 8 November 2019 / Revised: 9 December 2019 / Accepted: 12 January 2020 / Published: 1 February 2020

Abstract

Background: Clinical pathways are associated with improved adherence to clinical guidelines; however, most studies have evaluated pathways for a single intervention at a single institution. The objective of the present study was to develop and evaluate a method of measuring concordance with a population-based clinical pathway map to determine if that method could be feasible for assessing overall health system performance. Methods: Patients with stage ii or iii colon cancer diagnosed in 2010 were identified, and clinical data were obtained through linkages to administrative databases. Pathway concordance was defined a priori based on receipt of key elements of the Ontario Health (Cancer Care Ontario) colorectal pathway maps. For stages ii and iii colon cancer alike, concordance was reported as the proportion of patients receiving care that followed the predefined key elements of the pathway map. Regression analysis was used to identify predictors of concordant care. Results: Our study identified 816 patients with stage ii and 800 patients with stage iii colon cancer. Of the patients with stage ii disease, 70% (n = 571) received concordant care. Of the patients with stage iii disease, results showed high concordance for all key elements except receipt of chemotherapy, leading to an overall concordance rate of 39% for that cohort. Conclusions: Our method of measuring concordance was feasible on a population-based level, but future studies to validate it and to develop more sophisticated methods to measure concordance in larger cohorts and various disease sites are necessary. Measurement of clinical pathway concordance on a population-based level has the potential to be a useful tool for assessing system performance.
Keywords: clinical pathways; concordance; quality improvement; system performance; colon cancer clinical pathways; concordance; quality improvement; system performance; colon cancer

Share and Cite

MDPI and ACS Style

Forster, K.; Tsang, K.; Li, S.; Ieraci, L.; Murray, P.; Woltman, K.J.; Chmelnitsky, D.; Holloway, C.M.B.; Kennedy, E.D. Can Concordance between Actual Care Received and a Pathway Map Be Measured on a Population Level in Ontario? A Pilot Study. Curr. Oncol. 2020, 27, 27-33. https://doi.org/10.3747/co.27.5349

AMA Style

Forster K, Tsang K, Li S, Ieraci L, Murray P, Woltman KJ, Chmelnitsky D, Holloway CMB, Kennedy ED. Can Concordance between Actual Care Received and a Pathway Map Be Measured on a Population Level in Ontario? A Pilot Study. Current Oncology. 2020; 27(1):27-33. https://doi.org/10.3747/co.27.5349

Chicago/Turabian Style

Forster, K., K. Tsang, S. Li, L. Ieraci, P. Murray, K.J. Woltman, D. Chmelnitsky, C.M.B. Holloway, and E.D. Kennedy. 2020. "Can Concordance between Actual Care Received and a Pathway Map Be Measured on a Population Level in Ontario? A Pilot Study" Current Oncology 27, no. 1: 27-33. https://doi.org/10.3747/co.27.5349

APA Style

Forster, K., Tsang, K., Li, S., Ieraci, L., Murray, P., Woltman, K. J., Chmelnitsky, D., Holloway, C. M. B., & Kennedy, E. D. (2020). Can Concordance between Actual Care Received and a Pathway Map Be Measured on a Population Level in Ontario? A Pilot Study. Current Oncology, 27(1), 27-33. https://doi.org/10.3747/co.27.5349

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