27219634

PMC4945364

Background and Objective

Quality measures used in pay-for-performance systems are intended to address specific quality goals, such as safety, efficiency, effectiveness, timeliness, equity and patient-centeredness. Given the small number of narrowly focused measures in prostate cancer care, we sought to determine whether adherence to any of the available payer-driven quality measures influences patient-centered outcomes, including health-related quality of life (HRQOL), patient satisfaction, and treatment-related complications.

Methods

The Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study is a population-based, prospective cohort study that enrolled 3708 men with clinically localized prostate cancer during 2011 and 2012, of whom 2601 completed the 1-year survey and underwent complete chart abstraction. Compliance with six quality indicators endorsed by national consortia was assessed. Multivariable regression was used to determine the relationship between indicator compliance and Expanded Prostate Cancer Index Composite (EPIC-26) instrument summary scores, satisfaction scale scores (SSS-CC) and treatment-related complications.

Results

Overall rates of compliance with these quality measures ranged between 64–88%. Three of the six measures were weakly associated with 1-year sexual function and bowel function scores (β −4.6 and 1.69,2.93, respectively; p ≤ 0.05) while the remaining measures had no significant relationship with patient-reported HRQOL outcomes. Satisfaction scores and treatment-related complications were not associated with quality measure compliance.

Conclusions

Compliance with available nationally-endorsed quality indicators, which were designed to incentivize effective and efficient care, was not associated with clinically important changes in patient-centered outcomes (HRQOL, satisfaction or complications) within 1-year.

CDC Public Access

U58 DP003931/DP/NCCDPHP CDC HHS/United States
N01 PC067009/CN/NCI NIH HHS/United States
R01 HS019356/HS/AHRQ HHS/United States
HHSN261201000035C/PC,CA/None/None
N01 PC067010/PC/NCI NIH HHS/United States
HHSN261201300071C/CA/NCI NIH HHS/United States
HHSN261201300011C/RC/CCR NIH HHS/United States
U58 DP003915/DP/NCCDPHP CDC HHS/United States
HHSN261201300021C/CA/NCI NIH HHS/United States
HHSN261201000035I/CA/NCI NIH HHS/United States
N01 PC067006/PC/NCI NIH HHS/United States
U58 DP003862/DP/NCCDPHP CDC HHS/United States
R01 HS022640/HS/AHRQ HHS/United States
HHSN261201300011I/CA/NCI NIH HHS/United States
HHSN261201300016C/CP/NCI NIH HHS/United States
HHSN261201300016I/CA/NCI NIH HHS/United States