Association of Core Measure and Hospital Volume to Colorectal Cancer Mortality and Recurrence
Date Issued
2011
Date
2011
Author(s)
Huang, Siao-Fang
Abstract
Background：Many studies have been conducted the relationship between hospital volume and outcome, however the relationship has not to be determined for resection of colorectal cancer in Taiwan. This study examines the association of hospital volume with mortality and recurrence in colorectal cancer patients.It also examines the associations of core measure with outcome and the impact of core measure on the relationship between volume and outcome.
Method：All newly diagnosed with colorectal cancer registered at Taiwan Cancer Databased in the year 2004 were entered into the study. The population consisted of 4254 patients from 29 hospitals. Data was analyzed using multilevel logistic regression to adjust factors for different nested levels of patients and hospitals.
Results：In patient level, the adherence of core measure has influence on the 5 year mortality and recurrence. In hospital level, the adherence of core measure does not have impact on outcome. And after controlling other fators, hospital volume significantly impacts on the 5 year mortality, but not on 5 year recurrence. Besides, the relationship between hospital volume and 5 year mortality is stronger in hospitals with high adherence of core measure than in hospitals with low adherence of core measure.
Conclusion：According to the results, the hospital volume has impact on the 5 year mortality. This study supports the strategy of surgery centralization. This study also suggests that hospitals could invest more resources to improve the quality of care. In high quality hospital, by increasing hospital volume can have the synergy results.
Subjects
Hospital volume
Colorectal core measure
Mortality
Recurrence
Multilevel analysis
SDGs
Type
thesis
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