Variation in the technical support of radiation oncology in different practice settings

Two surveys of radiation therapy practice in the United States have been analyzed to reflect the technical support and processes of patient evaluation in different types of facilities. A 1986 random sample of facilities including single treatment unit free standing, single treatment unit hospital based, multiple treatment unit free standing, and multiple unit hospital based facilities have been surveyed to assess procedures, support, services, and equipment. The single treatment unit free standing and the single treatment unit hospital based facilities have the fewest support services, lower energy equipment, infrequent electron capability, and less than half are able to simulate complex disease processes with a dedicated simulator. A separate survey of practice in 1983 assessed compliance with important aspects of patient evaluation and treatment. In this survey single unit facilities showed greater variability above and below the national average than facilities with multiple treatment units and free standing facilities showed greater variation above and below the national average than hospital based facilities. This study identifies specific areas for improvement in the structure and practice of radiation oncology. It is still true that one can not indict broad categories of practice but must evaluate the individual facility.