Will Patients Benefit from Regionalization of Gynecologic Cancer Care? Regionalization for GYN-ONC
2009

Impact of Hospital Volume and Teaching Status on Gynecologic Cancer Outcomes

Sample size: 48981 publication 10 minutes Evidence: moderate

Author Information

Author(s): Brookfield Kathleen F., Cheung Michael C., Yang Relin, Byrne Margaret M., Koniaris Leonidas G.

Primary Institution: University of Miami Miller School of Medicine

Hypothesis

Does the volume and teaching status of hospitals affect patient outcomes for gynecologic cancers?

Conclusion

Overall, no significant difference in long-term survival was observed for gynecologic malignancies based on hospital teaching or volume status.

Supporting Evidence

  • Patients treated at high-volume centers were significantly younger.
  • Surgery and chemotherapy were associated with improved survival.
  • Five-year survival rates for cervical cancer were 61.7%.

Takeaway

This study looked at whether patients with gynecologic cancers do better when treated at bigger or teaching hospitals, and found that it doesn't really make a difference in the long run.

Methodology

Data from the Florida Cancer Data System was analyzed for patients treated for gynecologic cancers from 1990 to 2000.

Potential Biases

Potential bias due to incomplete data on treating physician specialty and patient demographics.

Limitations

The study did not account for clustering effects in patient outcomes and lacked data on co-morbidities.

Participant Demographics

Majority were Caucasian (89.1%) and non-Hispanic (89.6%), with a significant number of patients over 65 years old.

Statistical Information

P-Value

p<0.01

Confidence Interval

95% CI

Statistical Significance

p<0.01

Digital Object Identifier (DOI)

10.1371/journal.pone.0004049

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