University of Twente Student Theses
A comparison of the quality of breast cancer care in Norway and the Netherlands.
Hamersma, D.T. (2020) A comparison of the quality of breast cancer care in Norway and the Netherlands.
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| Abstract: | Breast cancer is the most common cancer and one of the leading causes of death among women. To support the delivery of the highest quality of care provided by hospitals in Europe to women with breast cancer, the European Society of Breast Cancer Specialists defined quality indicators that act as a quality instrument for hospitals to standardize the quality assurance of these hospitals and set a standard minimum of care. Comparing quality indicators amongst countries may identify areas for improvement, opens discussions and further improve the quality of breast cancer care. In this study, comparisons were made of two geographically different countries. Anonymized data was gathered from the Netherlands Cancer Registry and the Cancer Registry of Norway. The data selected was grouped in two populations, all female invasive breast cancer patients diagnosed in 2017 and 2018 in the Netherlands and all female invasive breast cancer patients diagnosed in 2017 and 2018 in Norway. Five European Society of Breast Cancer Specialists quality indicators were selected for assessment. Two based on MRI availability, two on appropriate surgical approaches and one on post-operative radiotherapy. The quality indicator outcomes were calculated before and after a federated Propensity Score Stratification on the two populations to reduce the bias of confounding by indication. In total 39,163 female breast cancer patients were included. 32,786 from the Netherlands and 6377 from Norway. The balance did improve after Propensity Score Stratification of every quality indicator. The outcome of the first MRI availability quality indicator were in the Netherlands 37% and Norway 17.5%. The second MRI availability was in the Netherlands 83.3% and Norway 70.8%. The first quality indicator of the appropriate surgical approach was in the Netherlands 95.2% and Norway 91.5%. The second in the Netherlands 36% and Norway 37.4%. Lastly, the quality indicator on post-operative radiotherapy was in the Netherlands 94.9% and Norway 95.7%. In both countries four of five quality indicators were well above the minimum standard set by EUSOMA. The main differences between the countries are attributed to the implementation time of the guidelines. Both countries offer a high quality of breast cancer care compared to other countries and may yet improve even more in the future. |
| Item Type: | Essay (Master) |
| Clients: | IKNL, Utrecht/Eindhoven, Netherlands Cancer Registry of Norway, Oslo, Norway |
| Faculty: | TNW: Science and Technology |
| Subject: | 02 science and culture in general, 44 medicine |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/85725 |
| Export this item as: | BibTeX EndNote HTML Citation Reference Manager |
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