Show simple item record

dc.contributor.authorDudeja, Vikas
dc.contributor.authorGay, Greer
dc.contributor.authorHabermann, Elizabeth B.
dc.contributor.authorTuttle, Todd M.
dc.contributor.authorTseng, Jennifer F.
dc.contributor.authorFeig, Barry W.
dc.contributor.authorAl-Refaie, Waddah B.
dc.date2022-08-11T08:10:58.000
dc.date.accessioned2022-08-23T17:26:39Z
dc.date.available2022-08-23T17:26:39Z
dc.date.issued2012-02-01
dc.date.submitted2012-09-19
dc.identifier.citation<p>Ann Surg Oncol. 2012 Feb;19(2):365-72. Epub 2011 Aug 12. <a href="http://dx.doi.org/10.1245/s10434-011-1973-z" target="_blank">Link to article on publisher's site</a></p>
dc.identifier.issn1068-9265 (Linking)
dc.identifier.doi10.1245/s10434-011-1973-z
dc.identifier.pmid21837530
dc.identifier.urihttp://hdl.handle.net/20.500.14038/49688
dc.description.abstractBACKGROUND: Hospital attributes have been shown to impact short- and long-term outcomes after cancer surgery. However, the effect of hospital attributes on processes of cancer care in terms of delivery of guideline recommended care has not been evaluated. We examined the impact of hospital attributes (volume and type) on guideline-recommended care in patients treated for gastric cancer. METHODS: We identified patients who were surgically treated for gastric cancer at Commission on Cancer (CoC) hospitals from 2001 to 2006. Patient, tumor, and treatment factors were compared separately by hospital volume and type. Multivariable analyses were used to evaluate the impact of hospital attributes on delivery of guideline recommended gastric cancer care: adequate lymphadenectomy (>/=15 lymph nodes), and adjuvant multimodality therapy (for AJCC Ib-IVM0), controlling for covariates. RESULTS: More than 1,490 CoC hospitals performed 37,124 gastrectomies. High-volume and teaching CoC hospitals were more likely to treat younger patients, non-whites, patients with lower AJCC stage, and to perform adequate lymphadenectomy than low-volume and community CoC hospitals (p ≤ 0.001). Hospital volume and type, however, were not associated with receipt of adjuvant multimodality therapy. These associations persisted in our multivariable analyses to show that CoC hospital attributes were associated with adequate lymphadenectomy, but marginally predictive of receipt of adjuvant multimodality therapy. CONCLUSIONS: The strong association between CoC hospital volume or type and guideline-recommended care diminishes after gastric cancer surgery. Variations in referral, insurance, and documentation patterns are potential explanations for these findings. These results highlight some limitations of using hospital attributes as a sole predictor of optimal cancer care.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=21837530&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1245/s10434-011-1973-z
dc.subjectAdenocarcinoma
dc.subjectAged
dc.subjectCarcinoma, Signet Ring Cell
dc.subjectClinical Competence
dc.subjectFemale
dc.subjectGastrectomy
dc.subjectHospitals
dc.subjectHumans
dc.subjectLymph Node Excision
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNeoplasm Staging
dc.subject*Practice Guidelines as Topic
dc.subjectStomach Neoplasms
dc.subjectSurvival Rate
dc.subjectTreatment Outcome
dc.subjectOncology
dc.subjectSurgery
dc.titleDo hospital attributes predict guideline-recommended gastric cancer care in the United States
dc.typeArticle
dc.source.journaltitleAnnals of surgical oncology
dc.source.volume19
dc.source.issue2
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/surgery_pp/116
dc.identifier.contextkey3335957
html.description.abstract<p>BACKGROUND: Hospital attributes have been shown to impact short- and long-term outcomes after cancer surgery. However, the effect of hospital attributes on processes of cancer care in terms of delivery of guideline recommended care has not been evaluated. We examined the impact of hospital attributes (volume and type) on guideline-recommended care in patients treated for gastric cancer.</p> <p>METHODS: We identified patients who were surgically treated for gastric cancer at Commission on Cancer (CoC) hospitals from 2001 to 2006. Patient, tumor, and treatment factors were compared separately by hospital volume and type. Multivariable analyses were used to evaluate the impact of hospital attributes on delivery of guideline recommended gastric cancer care: adequate lymphadenectomy (>/=15 lymph nodes), and adjuvant multimodality therapy (for AJCC Ib-IVM0), controlling for covariates.</p> <p>RESULTS: More than 1,490 CoC hospitals performed 37,124 gastrectomies. High-volume and teaching CoC hospitals were more likely to treat younger patients, non-whites, patients with lower AJCC stage, and to perform adequate lymphadenectomy than low-volume and community CoC hospitals (p ≤ 0.001). Hospital volume and type, however, were not associated with receipt of adjuvant multimodality therapy. These associations persisted in our multivariable analyses to show that CoC hospital attributes were associated with adequate lymphadenectomy, but marginally predictive of receipt of adjuvant multimodality therapy.</p> <p>CONCLUSIONS: The strong association between CoC hospital volume or type and guideline-recommended care diminishes after gastric cancer surgery. Variations in referral, insurance, and documentation patterns are potential explanations for these findings. These results highlight some limitations of using hospital attributes as a sole predictor of optimal cancer care.</p>
dc.identifier.submissionpathsurgery_pp/116
dc.contributor.departmentDepartment of Surgery
dc.source.pages365-72


This item appears in the following Collection(s)

Show simple item record