Quality of supportive care for patients with advanced lung cancer in the Veterans Health Administration.

BACKGROUND: Morbidity related to cancer and its treatment remains a significant source of human suffering and a challenge to the delivery of high-quality care. OBJECTIVES: To develop and apply quality indicators to evaluate quality of supportive care for advanced lung cancer in the Veterans Health Administration (VHA) and examine facility-level predictors of quality. METHODS: We evaluated supportive care quality using 12 quality indicators. Data were taken from VHA electronic health records for incident lung cancer cases occurring during 2007. Organizational characteristics of 111 VHA facilities were examined for association with receipt of care. LIMITATIONS: Not all supportive care was evaluated. Care processes identified as present at facilities may not have been applied to cohort patients. Facility-level results may be influenced by errors in attributing a patient's care to the correct facility. CONCLUSIONS: Quality indicators for supportive cancer care can be developed and applied in large evaluations using electronic health record review. This study confirmed high-quality supportive care, while identifying significant facility-level variation in VHA.