Assessment of the effectiveness of care in certified cancer centres for eight cancer entities via a retrospective cohort study based on secondary data from statutory health insurance funds and population-based clinical cancer registries.
Cancer constitutes the second most frequent cause of death in Germany. To maintain a high quality of treatment, the national cancer plan aims at a unified certification of cancer centres. The project "Wirksamkeit der Versorgung in onkologischen Zentren" (WiZen) investigates effects of treatments in certified cancer centres across large populations and different cancer entities in comparison to hospitals that do not hold a certificate. WiZen is a retrospective comparative cohort study that analyzes incident cases of eight types of cancer diagnosed within 2009-2017 based on nationwide health insurance data provided by WIdO (the AOK research institute) and data from regional clinical cancer registries (CCR) for the period 2006-2017. These eight types of cancer are colorectal cancer, pancreatic cancer, breast cancer, gynecologic tumors, lung cancer, prostate cancer, head and neck tumors and neuro-oncological tumors.
Study Type
OBSERVATIONAL
Enrollment
670,000
Oncological certification encompasses a variety of criteria such as treatment according to the clinical guidelines, staffing, technical infrastructure, minimum caseloads, and multidisciplinary care.
Technische Universität Dresden
Dresden, Saxony, Germany
Overall survival
Survival after first hospitalization due to cancer
Time frame: first hospitalization (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]), up to 31/12/2017
1- and 5-year survival
1- and 5-year survival after first hospitalization due to cancer
Time frame: first hospitalization (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]) with 1 or 5-year follow-up, respectively
30-day mortality
30-day mortality after first hospitalization due to cancer
Time frame: first hospitalization (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]) with 30 days follow-up
2-, 3-, 4-year survival
2-, 3-, 4-year survival after first hospitalization due to cancer
Time frame: first hospitalization (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]) with 2,3, or 4-year follow-up, respectively
Recurrence-free survival
Recurrence-free survival after cancer diagnosis
Time frame: cancer diagnosis (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]), up to 31/12/2017
Cumulative recurrence rate
Cumulative recurrence rate after cancer diagnosis
Time frame: cancer diagnosis (starting from 01/01/2009 [WIdO] or 01/01/2006 [CCR]), up to 31/12/2017
Complications due to surgery
Complications due to cancer surgery
Time frame: date of initial cancer surgery with entity-specific follow-up
Successive resection
Second resection due to cancer
Time frame: second resection within three months of initial cancer surgery
Entity-specific outcomes defined by clinical experts
1. Fractions of entity-specific surgery techniques 2. For head-neck-tumours: aspiration pneumonia due to swallowing dysfunctions
Time frame: 2009-2017 [CCR] or 2006-2017 [WIdO]
Fraction of patients
Fraction of patients in certified centres and in non-certified hospitals over time
Time frame: 2009-2017
Regional differences
Differences across outcomes in different counties or federal states
Time frame: 2009-2017
Differences in patient characteristics
Differences in demographic characteristics, disease severity and risk factors across certified centres/non-certified hospitals
Time frame: 2009-2017 [CCR] or 2006-2017 [WIdO]
Pathways of treatment
Patient's treatment pathways among general practitioners, specialists, and hospitals w.r.t. certification
Time frame: 2009-2017
Severity Levels in insurance data
Deduction of cancer severity levels through linkage of health insurance and cancer registry data
Time frame: 2009-2017
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