Division of Health Services Research

Takahiro Higashi, Taro Tomizuka, Momoko Iwamoto, Satoru Kamitani, Izumi Inoue, Naoki Sakakibara, Tomone Watanabe, Fumiaki Nakamura, Ryoko Rikitake, Yoichiro Tsukada, Takehiro Sugiyama, Rei Goto, Kaoru Konno, Kazumi Shimamura

Research activities

The Division of Health Services Research conducts research that contribute to the improvement of the quality of cancer care in Japan through meaningful evaluation of health systems and health policy performance.

1.Cancer registry-linked DPC database

As part of our ongoing initiative to monitor the quality of cancer care in Japan using a database of cancer registry-linked diagnosis procedure combination (DPC) data, we continuously built the database for cancer patients diagnosed in 2014 in cooperation with the Center for Cancer Registries. We collected DPC data from a total of 424 hospitals comprised of 297 designated cancer center hospitals, and 129 other hospitals.

Our division used a modified free encryption software designed to support different file formats used by various hospitals, which allowed multiple data sources to be synthesized smoothly into a single database.

2.Rare Cancer Control Policy

Our division has been assigned with the administrative task of facilitating the Working Group for the Rare Cancer Control Policy by the Ministry of Health, Labour and Welfare. In 2016, our division hosted two subcommittee meetings: one for soft tissue sarcomas of the extremities, and another for eye tumor which had the highest frequency of consultation to rare cancer-hotline considering the small incidence.

3.Monitoring and Evaluation of the National Cancer Control Programs

Our division continued to implement an evaluation program in order to measure the performance of the nation's Cancer Control Programs. This year, we focused mainly on two unfinished cancer control evaluations: systems at work that support patients to continue working while undergoing cancer treatment at small or medium sized establishments, and the evaluation of designated cancer center hospitals by local non-designated hospitals and clinics.

Achievements

In the process of the ongoing quality indicator (QI) research project, we successfully included 13 and 10 newly devised QIs for analysis in the field of stomach and lung cancer. Analysis was performed on all newly devised QIs coupled with the 12 existing old QIs. Hospital cancer registry data for patients diagnosed in 2013 and the DPC data for the same patients were collected from a total of 297 hospitals that included both designated and non-designated cancer center hospitals. The results were fed back to each participating hospital and we prompted them to input their reasons for non-adherence. To expand the scope of quality monitoring, our division hosted a cervical cancer expert committee, producing a new set of QIs for cervical cancer. These QIs were also analyzed and then fed back to the hospitals.

Research training and education

Our division accepted three visiting researchers and a nursing graduate student, and provided continuous education. We hosted four medical students from the University of Tokyo for the Clerkship in Public Health. Our division also established an Affiliated Graduate Programs with the University of Tokyo's Department of Public Health/ Health Policy, and opened doors to graduate students who are interested in gaining hands-on public health training.

Future prospects

Our division envisions the facilitation of evidence-based policymaking, and improvement for the care of cancer patients by monitoring the performance of cancer policy and quality of care among cancer treatment centers across the country. To serve this purpose, we are working to provide an information exchange platform along with a solid baseline data for specialists and various stakeholders designed to foster evidence based exchange of ideas for cancer policy planning.