PresentationQuality of pancreatic cancer care at Veterans Administration compared with non-Veterans Administration hospitals
Section snippets
Patients
The National Cancer Data Base (NCDB) is a program of the American College of Surgeons’ Commission on Cancer (CoC) and receives operational support from the American Cancer Society. The NCDB has been collecting data on newly diagnosed cancers since 1985 [21]. The NCDB now contains data on >20 million patients from >1,440 hospitals, including information on patients (demographics, diagnosis, treatment, recurrence, and survival) as well as health systems information (hospital type, teaching
Results
From the NCDB (1985 to 2004), we identified 31,568 clinical pretreatment stage I and II patients with pancreatic adenocarcinoma. Five hundred thirteen (2%) patients were treated at VA hospitals; 12,756 (38%) were treated at academic hospitals; and 18,299 (54%) were treated at community hospitals. A higher percentage of VA hospital patients were male, younger, and black; had lower-grade tumors, lower incomes, and less education; and presented with higher Charlson comorbidity scores (P < .0001) (
Comments
Pancreatic cancer is a formidable disease with complex surgical management and adjuvant-therapy decisions. The quality of cancer care at VA hospitals has often been questioned; however, no previous study has directly compared pancreatic cancer care at VA hospitals to that at a large national sample of non-VA hospitals. This study demonstrates that treatment utilization, perioperative mortality, and long-term outcomes were comparable at VA and academic hospitals.
Previous studies have shown that
Acknowledgments
K.Y.B. was supported by the American College of Surgeons Clinical Scholars in Residence program and a research grant from the Department of Surgery, Northwestern University.
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