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Association of surgeon volume and hospital volume with the outcome of patients receiving definitive surgery for colorectal cancer: A nationwide population-based study
- Source :
- Cancer. 121:2782-2790
- Publication Year :
- 2015
- Publisher :
- Wiley, 2015.
-
Abstract
- BACKGROUND Patients with colorectal cancer (CRC) who undergo cancer surgeries with higher-volume providers may have better outcomes. The current debate focuses on whether it is hospital volume or surgeon volume that matters more. METHODS The authors conducted a nationwide population-based study in Taiwan that enrolled all patients who underwent definitive surgery for newly diagnosed CRC between 2005 and 2011. All patients were divided into 4 quartiles according to hospital and surgeon volume. The main outcome was the 5-year mortality rate, which was analyzed using a frailty model for Cox regression. The authors also conducted fixed and random effects multivariate regression models to examine short-term outcomes and resource use, including operative mortality, hospital stay, emergency department visits within 30 days, and medical expenses. Analyses were adjusted for patient and provider characteristics. RESULTS A total of 61,728 patients with CRC were included in the current study. The 5-year mortality rates were 38.7%, 32.8%, 32.0%, and 29.1% in descending order of hospital volume quartiles and were 41.4%, 34.1%, 29.8%, and 27.4% in descending order of surgeon volume quartiles. After adjustment for the individual and provider characteristics, surgeon volume, but not hospital volume, remained a significantly predictive factor of death (P
- Subjects :
- Cancer Research
medicine.medical_specialty
education.field_of_study
Proportional hazards model
business.industry
Colorectal cancer
Mortality rate
medicine.medical_treatment
General surgery
Population
Cancer
Emergency department
Lower risk
medicine.disease
Surgery
Oncology
medicine
education
business
Colectomy
Subjects
Details
- ISSN :
- 0008543X
- Volume :
- 121
- Database :
- OpenAIRE
- Journal :
- Cancer
- Accession number :
- edsair.doi...........19865f41e5b9072c64f0cc26b4943d14