Feasibility of Healthcare Quality Indicators for Breast Cancer in China: A Real-Word Study

BACKGROUND: Breast cancer (BC) has become the most prevalence cancer among Chinese women, and more reasonable medical quality control is urgently needed. Oncology Professional Quality Control Indicators (2023 edition) has been published by the National Health Commission of China, no study has yet verified its feasibility in real-world settings.

OBJECTIVES: To assess the feasibility of BC quality indicators from the Oncology Professional Quality Control Indicators (2023 edition) using real-word data in China.

METHODS: A retrospective study was conducted utilizing data collected from the Electronic Medical Records (EMR) of BC patients across more than 10 hospitals in Northern, Eastern, and Central China from 2022 to 2023. A set of 12 quality indicators were calculated, including 5 diagnostic-related indicators and 7 treatment-related indicators.

RESULTS: A total of 17,402 BC patients were identified in the study. For treatment quality indicators, 89.74% of patients with advanced metastatic BC received first-time systemic treatment, 50.11% of hormone receptor-positive BC patients received adjuvant endocrine therapy post-surgery. Only 22.05% of BC patients receiving anti-HER-2 targeted therapy were confirmed to be HER-2 positive. The percentage of BC patients receiving radiotherapy after breast-conserving surgery and modified radical mastectomy were both below 25%. Three quality indicators related to BC diagnosis were all below 50%, indicating that there may be inconsistencies in diagnostic practices and limited availability of detailed medical record data in China. Additionally, four indicators could not be reasonably calculated based on the available data.

CONCLUSIONS: In real-world BC medical quality control practices in China, some treatment-related indicators are feasible, but there remains considerable potential for improvement in compliance with many indicators, particularly at the diagnosis level. More work should be done in the future including enhancing the standardization of diagnosis and treatment for BC patients and optimization of data collection methods for particular indicators.