Background/Objectives: The COVID-19 pandemic led to significant disruptions in healthcare systems, particularly impacting cancer care through delays in diagnoses and treatments. Quality indicators (QIs) are essential tools for monitoring healthcare performance, yet existing QIs may not be suited for crises. This study aimed to develop a set of hospital-based QIs tailored to assess the impact of care reorganization during health crises across four cancer types: breast cancer, hepatocellular carcinoma, gynecological cancers (excluding ovarian cancer), and peritoneal carcinomatosis. Methods: A multidisciplinary steering committee (SC) conducted a five-stage process, including a literature review, indicator selection, content validation via the RAND/UCLA method, final validation by the SC, and a pilot feasibility study. QIs were assessed based on clinical relevance, reproducibility, sensitivity to change, and feasibility. Expert panels evaluated and validated the indicators in two rounds of voting. Results: Among 150 initially identified QIs, 49 were validated: 12 for breast cancer, 11 for hepatocellular carcinoma, 8 for gynecological cancers, and 18 for peritoneal carcinomatosis. Most (92%) were process indicators, covering diagnosis, treatment, and care delays. Two common indicators were identified across all four cancers: multidisciplinary team meeting discussions and psychological support consultations. Conclusions: This study demonstrates the feasibility of developing crisis-responsive QIs to monitor cancer care during health system disruptions. Future work will focus on their real-time implementation, validation in international settings, and integration into healthcare policies to enhance crisis preparedness.
背景/目的：COVID-19大流行对医疗系统造成严重干扰，尤其通过延迟诊断和治疗影响了癌症护理。质量指标是监测医疗绩效的重要工具，但现有指标可能不适用于危机情境。本研究旨在开发一套适用于医院的定制化质量指标，用于评估健康危机期间乳腺癌、肝细胞癌、妇科癌症（卵巢癌除外）和腹膜癌转移四种癌症类型的护理重组影响。方法：多学科指导委员会采用五阶段流程，包括文献综述、指标筛选、基于RAND/UCLA方法的内容验证、指导委员会终审及试点可行性研究。质量指标从临床相关性、可重复性、变化敏感性和可行性四个维度进行评估。专家小组通过两轮投票对指标进行评审和验证。结果：在初步确定的150个质量指标中，最终验证通过49个：乳腺癌12项、肝细胞癌11项、妇科癌症8项、腹膜癌转移18项。其中92%为过程指标，涵盖诊断、治疗和护理延迟等环节。研究发现四项癌症类型存在两个共同指标：多学科团队会议讨论和心理支持咨询。结论：本研究证实了开发危机应对型质量指标以监测医疗系统紊乱期间癌症护理的可行性。未来工作将聚焦于指标的实时实施、国际环境验证，以及将其整合到医疗政策中以提升危机应对能力。
肿瘤(癌症)患者之家