Replication Data for: Quality of EOL care for Medicare decedents at minority-serving cancer centers: A retrospective study

<p>This project is an update to the Dartmouth Atlas Cancer Report profiling NQF EOL measures using our previously-developed algorithm using the most up-to-date Medicare claims data (2012-Q2 2017). In that algorithm, we categorize hospitals into the following four mutually exclusive types: members of the National Comprehensive Cancer Network (NCCN; n=30); hospitals outside the network that were designated Comprehensive Cancer Centers by the National Cancer Institute (NCI; n=24); hospitals that were not in the network or designated comprehensive cancer centers but that were academic medical centers (n=161); and community hospitals, those institutions not in the above groups (n=4,240). In the current study, we focus on National Comprehensive Cancer Network and Comprehensive Cancer Center hospitals because they set national standards for high quality care.</p>

<p>The algorithm used to profile cancer centers’ EOL quality follows three steps:</p>
<ul>
<li>1) Define the cohort; </li>
<li>2) Attribute cohort member’s medical care to the hospital providing largest number of hospitalizations for cancer care in the last six months of life; </li>
<li>3) Calculate EOL quality measures in the six months preceding death for each patient assigned to a National Comprehensive Cancer Network hospital or NCI-designated Comprehensive Cancer Centers. </li>
</ul>
<p>The cohort includes fee-for-service Medicare beneficiaries who died at ages 66–99, had continuous inpatient and outpatient Medicare insurance (Parts A, B, and D) in the last six months of life, and had at least one hospital discharge or at least two clinician visits in the last six months of life with cancer diagnosis codes associated with a high risk of near-term death and at least one hospital admission for cancer care in the last six months of life. These criteria exclude patients with many common cancers not associated with a high likelihood of dying in the near term. We calculate NQF measures using our linked Medicare Provider Analysis and Review (MedPAR) files, hospice files, Part B and Part D files.</p>