Do Hospitals that Serve a High Percentage of Medicaid Patients Perform Well on Evidence-based Guidelines for Colon Cancer Care?
Autor: | Rhoads, Kim E., Ngo, Justine V., Yifei Ma, Lyen Huang, Welton, Mark L., Dudley, R. Adams |
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Předmět: |
COLON tumors
LEGAL compliance CONFIDENCE intervals REPORTING of diseases EPIDEMIOLOGY HOSPITALS LONGITUDINAL method MEDICAID EVALUATION of medical care MEDICAL quality control MEDICAL protocols PHYSICIANS PROFESSIONS RESEARCH funding EVIDENCE-based medicine COMORBIDITY PHYSICIAN practice patterns LOGISTIC regression analysis PROFESSIONAL practice DATA analysis CROSS-sectional method RETROSPECTIVE studies TUMOR treatment |
Zdroj: | Journal of Health Care for the Poor & Underserved; Aug2013, Vol. 24 Issue 3, p1180-1193, 14p |
Abstrakt: | Background. Previous work suggests hospitals serving high percentages of patients with Medicaid are associated with worse colon cancer survival. It is unclear if practice patterns in these settings explain differential outcomes. Hypothesis: High Medicaid hospitals (HMH) have lower compliance with evidence-based care processes (examining 12 or more lymph nodes (LN) during surgical staging and providing appropriate chemo- therapy). Methods. Retrospective analysis of stage I-III colon cancers from California Cancer Registry (1996-2006) linked to discharge abstracts and hospital profiles predicted hospital compliance with guidelines and trends in compliance over time. Results. Cases (N=60,000) in 439 hospitals analyzed. High Medicaid hospital settings had lower odds of compliance with the 12 LN exam (OR |
Databáze: | Complementary Index |
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