Benchmarking Cancer Quality Indicators by State in Australia: A Comparison of Cancer Care and Outcomes Between Queensland and Victoria.

Abstract

Aims: Benchmarking quality indicators between jurisdictions provides an opportunity to identify unwarranted variations. This study compared statewide treatment and survival information for cancer between Queensland and Victoria.

Methods: Population-based data were obtained separately for residents of the two states diagnosed with selected cancers between 2017 and 2021. Eleven indicators are reported involving treatments received, timeliness of treatment, and outcomes. Individual-level data were analyzed within each state to preserve governance requirements. Aggregated results were then assessed using univariate Poisson models and reported as incidence or mortality rate ratios (IRRs/MRRs) for Queensland in reference to Victoria.

Results: The study cohort comprised 189,689 people. Around three-quarters (79% Queensland, 77% Victoria) received treatment. Variations in specific treatments were observed by type of cancer and state; for example, Queensland patients were more likely to receive intravenous systemic therapy for liver cancer (IRR = 1.62, 95% confidence interval [95% CI] 1.46-1.80), whereas brain cancer patients in Queensland were less likely to receive surgery compared with Victoria (IRR = 0.85, 95% CI 0.81-0.90; both p < 0.001). Treatment tended to be timelier in Victoria (overall IRR = 0.87 for Queensland, 95% CI 0.86-0.88; p < 0.001). Surgical mortality was low in both states, although brain cancer carried a higher risk. One-year survival was generally similar across both states, apart from upper gastrointestinal cancer (65% in Queensland compared to 61% in Victoria, IRR = 1.07, 95% CI 1.03-1.10; p < 0.001).

Conclusion: This project demonstrates the mutual benefit of identifying areas of improvement and serves as a blueprint for other Australian states to join nationwide reporting to drive best practice in healthcare performance for people with cancer.