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Interhospital differences in cancer survival.

C J Mettlin, E R Schoenfeld, N Natarajan

Journal of Chronic Diseases

|January 1, 1987

Summary

Hospital cancer survival rates vary significantly, but patient factors like disease stage and tumor type are more influential than hospital characteristics. Specific treatment patterns, however, show some association with better patient outcomes.

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Area of Science:

Oncology
Health Services Research
Public Health

Background:

Significant variations exist in cancer survival rates across U.S. hospitals.
Understanding factors influencing these survival disparities is crucial for improving cancer care.

Purpose of the Study:

To investigate the relationship between hospital characteristics and cancer survival rates for breast cancer, prostate cancer, and Hodgkin's disease.
To identify specific patterns of care associated with better or worse survival outcomes.

Main Methods:

Utilized data from the American College of Surgeons patient care studies and American Hospital Association surveys.
Employed multivariate analyses to examine patient, disease, treatment, and institutional characteristics.
Calculated survival rates for specific cancer types: breast cancer, prostate cancer, and Hodgkin's disease.

Main Results:

Hospital affiliation, residency training, and community size were not significantly related to cancer survival.
Specific treatment patterns, such as staging laparotomy for Hodgkin's disease and bone scanning for prostate cancer, were linked to improved survival.
Differences in survival were primarily driven by patient characteristics, disease stage, and tumor histology, rather than hospital-level factors.

Conclusions:

Hospital characteristics have a limited direct impact on cancer survival rates compared to intrinsic patient and disease factors.
Certain evidence-based treatment patterns are associated with better survival outcomes across different cancer types.
Findings can inform future public health interventions aimed at reducing cancer mortality.

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