High hospital volume is associated with more consistent long-term mortality rates

M. Curry, A. Lipitz-Snyderman, D. Rubin, Diane G. Li, Elaine Duck, M. Radzyner, P. Bach
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Abstract

Long-term survival following cancer treatment is a widely accepted metric used to evaluate the quality of cancer care and varies between hospitals (1-3). Long-term survival takes years to evaluate, and these metrics reflect care quality from many years prior. Long-term survival has unknown applicability as a quality measure to evaluate current performance. It is important to determine if the structural lag in measurement limits the value of long-term survival measures meaningless as a tool for assessing current hospital performance. The study assesses the stability of hospitals’ performance over time based on its cancer patients’ fouryear survival. We hypothesized that hospitals’ four-year mortality ratio would be consistent over time, implying that patients could use such information when deciding where to get care. Additionally, since decades of research have demonstrated a relationship between higher surgical volume and better outcomes for hospitals, we set out to explore consistency by hospital volume (1,4).
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高医院容量与更一致的长期死亡率相关
癌症治疗后的长期存活率是一种广泛接受的用于评估癌症护理质量的指标,医院之间的差异(1-3)。长期生存需要数年的时间来评估,这些指标反映了多年前的护理质量。长期生存率作为评估当前绩效的质量衡量标准具有未知的适用性。重要的是要确定测量中的结构性滞后是否限制了长期生存测量的价值,而长期生存测量作为评估当前医院绩效的工具毫无意义。该研究根据癌症患者的四年生存率来评估医院绩效随时间的稳定性。我们假设,随着时间的推移,医院的四年死亡率将是一致的,这意味着患者在决定在哪里接受治疗时可以使用这些信息。此外,由于数十年的研究表明,更高的手术量与医院更好的结果之间存在关系,我们开始探索医院手术量的一致性(1,4)。
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