XXXX : the quality of care is linked to geographical and organisational determinants. A study in a French registry.

@entity1582 @entity1 @entity5
UNASSIGNED: @entity1582 is a haematological @entity5 whose care is spread over several specialities and provided by centres that various sizes, which raises the issue of equal opportunities in care access. Incident cases of @entity1582 between 2008 and 2010 were exhaustively identified by the Poitou-Charentes Cancer Registry. To ascertain the quality of care, the diagnosis, staging, and treatment administered were compared to international recommendations. Three hundred and sixty-seven @entity1 were included. The diagnostic procedure exhibited 98% compliance, the staging 58%, and treatment 89%. Concerning diagnostic and staging, non-compliance with recommendations was associated to the failure to perform collegiate case assessments in multidisciplinary team (MDT) meetings [OR 2.15 (1.15-4.04)], care provided at a secondary centre, and a distance between home and the centre of 5-25  km [2.16 (1.06-4.40)] and 25-50  km [2.86 (1.37-6.01)]. Regarding treatment, non-compliance with recommendations was associated with care provided at a secondary centre [5.28 (2.03-13.75)]. Finally, diagnosis, staging and treatment quality improved over time. This study underlines the need to improve the organisation of the healthcare offer, so that @entity1 can receive the best possible care. MDT seems to be the main means to improve quality of care.
