The impact of a multi-hospital network on the inequality in odds of receiving resection or ablation for synchronous colorectal liver metastases.

Autor: van der Ven RGFM; Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.; Department of Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands., Westra D; Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands., van Erning FN; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands., de Hingh IH; Department of Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.; Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands., Olde Damink SWM; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.; Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany., Paulus A; Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands.; Faculty of Health, Medicine and Life Sciences (FHML), School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands., Leclercq WKG; Department of Surgery, Máxima Medical Center, Eindhoven and Veldhoven, The Netherlands., den Dulk M; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.; Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany.
Jazyk: angličtina
Zdroj: Acta oncologica (Stockholm, Sweden) [Acta Oncol] 2023 Aug; Vol. 62 (8), pp. 842-852. Date of Electronic Publication: 2023 Aug 07.
DOI: 10.1080/0284186X.2023.2238545
Abstrakt: Background: This study investigates whether inequalities in the utilization of resection and/or ablation for synchronous colorectal liver metastases (SCLM) between patients diagnosed in expert and non-expert hospitals changed since a multi-hospital network started.
Materials and Methods: Patients diagnosed with SCLM between 2009 and 2020 were included. The likelihood of receiving ablation and/or resection was analyzed in the prenetwork (2009-2012), startup (2013-2016), and matured-network (2017-2020) periods.
Results: Nationwide, 13.981patients were diagnosed between 2009 and 2020, of whom 1.624 were diagnosed in the network. Of patients diagnosed in the network's expert hospitals, 36.7% received ablation and/or resection versus 28.3% in nonexpert hospitals ( p  < 0.01). The odds ratio (OR) of receiving ablation and/or resection for patients diagnosed in expert versus nonexpert hospitals increased from 1.38 ( p  = 0.581, pre-network), to 1.66 ( p  = 0.108, startup), to 2.48 ( p  = 0.090, matured-network). Nationwide, the same trend occurred (respectively OR 1.41, p  = 0.011; OR 2.23, p  < 0.001; OR 3.20, p  < 0.001).
Conclusions: Patients diagnosed in expert hospitals were more likely to receive ablation and/or resection for SCLM than patients diagnosed in non-expert hospitals. This difference increased over time despite the startup of a multi-hospital network. Establishing a multi-hospital network did not have an effect on reducing the existing unequal odds of receiving specialized treatment.
Synopsis: Specialized oncology treatments are increasingly provided through multi-hospital networks. However, scant empirical evidence on the effectiveness of these networks exists. This study analyzes whether a regional multi-hospital network was able to improve equal access to specialized oncology treatments.
Databáze: MEDLINE
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