The impact of Quality-Based Procedures on radical prostatectomy outcomes in Ontario
Abstract
Ontario’s new health funding model, Quality-Based Procedures (QBP), designated certain performance outcomes that would determine future cancer care funding. We examined pre-specified outcomes for radical prostatectomy, one of the procedures integrated into QBP funding in 2015. We conducted two retrospective studies using provincial administratively-linked databases, including patients who underwent radical prostatectomy between April 2010 and March 2019. Our first study evaluated the 30-day complication rate and the trend in surgical approach. Our second study compared QBP outcomes before and after implementation of the funding model. The first study demonstrated that complication rate improved over the study period, possibly due to a transition to robotic approach for radical prostatectomy. The second study showed that complication rate and length of stay did improve after implementation of QBP, but not clearly because of the model. Unplanned visit rate and Wait 2 time worsened significantly, and there was no change in re-operation rate.