Division of Health Services Research
Senior Staff Researcher
Taro Tomizuka, MD, PhD,
Momoko Iwamoto, MD, MPH, Satoru Kamitani, MD, PhD, Tomone Watanabe,RN,MSc
Izumi Inoue, MD, MPH, Yoichiro Tsukada, MD
Rei Goto, MD, PhD
Fumiaki Nakamura, MD, PhD, Ryoko Rikitake, MD, Naoki Sakakibara, RN, PhD, Takehiro Sugiyama, MD, PhD, Yasuo Hamamoto, MD, PhD, Yukari Isaka, RN, MS
Kaoru Konno, Kazumi Shimamura
The Division of Health Services Research conducts research that contributes to the improvement of the quality of cancer care in Japan through meaningful evaluation of health systems and health policy performance.
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 continued building the database for cancer patients diagnosed in 2013. The Division distributed 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. The database contains deidentified information on all procedures, tests, and prescriptions given to patients. We used the database to calculate 12 quality indicators (QIs) among 206 QIs that were previously developed by an expert panel led by Dr. Tomotaka Sobue, professor of Medicine at Osaka University, which ask if certain types of tests, procedures, or prescriptions were given to a specified set of patients, such as the proportion of stage III colorectal cancer patients that received adjuvant chemotherapy within eight weeks of surgery. Results of the QI scores were fed back to participating hospitals through an interactive website that allowed hospitals to compare its performance to other hospitals. A total of 182 hospitals participated in the first year we launched the program in 2013. This expanded to 232 hospitals in the following year and 297 hospitals in 2015.
Monitoring and Evaluation of National Cancer Control Programs
The Division conducted a national patient experience survey and mailed out roughly 15,000 surveys to cancer patients throughout the country. The purpose of the survey was to measure the performance of the nation's Cancer Control Program through patient evaluations. Results of the survey along with measured outcomes of other performance indicators were put together into a 300–page final report describing the significance of the indicators and the methods used to measure them in detail. The reports were printed and distributed to various stakeholders and prefectural policymakers.
Rare Cancer Policy
We conducted various analyses using cancer registry data and the cancer registry-linked DPC database to describe the distribution and patterns of care of rare cancer patients in Japan. We also surveyed clinicians concerning their opinions about the definition of "rare cancer" using epidemiological data, in order to create an agreeable and meaningful definition of the term. Findings from the analyses and survey were reported to the Ministry of Health, Labour, and Welfare's Commission Expert Group on Rare Cancer, and was used to further define rare cancer and discuss priority issues in Cancer Control Policy. The Division also hosted a symposium aiming to foster open discussion on the centralization of care for bone and soft-tissue tumors among clinicians who are daily engaged in the treatment of rare cancer patients. The Division has been assigned the administrative task of facilitating the Working Group for Rare Cancer Policy by the Ministry of Health, Labour, and Welfare in 2016.
Research training and Education
The Division received a continuous flow of physicians and graduate students for research training in 2015. We mentored two graduate students: one pursuing a clinical doctorate and another from a nursing-related doctorate program. We accepted four medical students from The University of Tokyo for a clerkship in Public Health. The Division also established an Affiliate Graduate Program with The University of Tokyo's Department of Public Health/Health Policy, opening the doors to graduate school students who are interested in gaining hands-on public health training.
The Division supports evidence-based policymaking and strives to improve the care of cancer patients by monitoring the performance of cancer policy and quality of care among cancer treatment centers across the country. In addition to the current activities, the Division is working to provide an information exchange platform for specialists and various stakeholders, designed to foster smooth communication and active exchange of ideas for cancer policy planning at the local government level. The Division will continue to endeavor to make clinically relevant and evidence-based policy recommendations in order to help implement meaningful cancer control programs in Japan.
List of papers published in 2015
Inoue I, Higashi T, Iwamoto M, Heiney SP, Tamaki T, Osawa K, Inoue M, Shiraishi K, Kojima R, Matoba M. A national profile of the impact of parental cancer on their children in Japan. Cancer Epidemiol, 39:838-841, 2015 [PubMed]
Iwamoto M, Higashi T, Miura H, Kawaguchi T, Tanaka S, Yamashita I, Yoshimoto T, Yoshida S, Matoba M. Accuracy of using Diagnosis Procedure Combination administrative claims data for estimating the amount of opioid consumption among cancer patients in Japan. Jpn J Clin Oncol, 45:1036-1041, 2015 [PubMed]
Tsukada Y, Nakamura F, Iwamoto M, Nishimoto H, Emori Y, Terahara A, Higashi T. Are hospitals in Japan with larger patient volume treating younger and earlier-stage cancer patients? An analysis of hospital-based cancer registry data in Japan. Jpn J Clin Oncol, 45:719-726, 2015 [PubMed]