Surgical Outcome ResearchHospital characteristics, clinical severity, and outcomes for surgical oncology patients
Section snippets
Patients and methods
After human subjects exempt review, we performed secondary analysis of linked data created by merging inpatient claims from the Pennsylvania Health Care Cost Containment Council, the Pennsylvania Cancer Registry, and the American Hospital Association annual survey data. The list of National Cancer Institute's11 clinical and comprehensive cancer centers available from the NCI's website, and a list of approved cancer programs provided by the American College of Surgeons, were used to identify
Clinical severity by hospital characteristics
Table I presents differences in clinical severity and cancer severity by hospital characteristics (the clinical variables for the entire sample are presented in the first column). The mean age of the sample was 68.3 years, and approximately one third of study patients were below the age of 65. The majority of patients received colorectal or prostate resections.
Admission severity and cancer severity differed significantly by hospital characteristics. Patients in hospitals with NCI cancer centers
Discussion
We report significant differences in clinical severity, cancer severity, and outcomes for surgical oncology patients by hospital characteristics. Contrary to what might be expected, severity of illness does not appear uniformly higher in NCI cancer centers. However, NCI cancer centers in our study achieved lower mortality rates than would be expected on the basis of case mix. In other types of hospitals studied, more favorable mortality rates were found to be largely a product of less severely
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Supported by National Institute of Nursing Research R01-NR04513, American Cancer Society, DSCN-03-202-01-SCN, the Oncology Nursing Society via the Pennsylvania Tobacco Settlement Funds, and a predoctoral training grant from the National Institute of Nursing Research, T32-NR07104.