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Is the performance of cancer services influenced more by hospital factors or by specialization?

McCarthy, M; Datta, P; Sherlaw-Johnson, C; Coleman, M; Rachet, B; (2008) Is the performance of cancer services influenced more by hospital factors or by specialization? J PUBLIC HEALTH-UK , 30 (1) 69 - 74. 10.1093/pubmed/fdm081. Green open access

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Abstract

The Cancer Plan for England, introduced in 2000, has promoted cancer service specialization. We have investigated how far specialization and general hospital factors each contributed to service performance for four common cancers-breast, colorectal, lung and prostate-at the time of the Cancer Plan.Performance measures of service standards, waiting time to treatment, satisfaction with care, in-hospital mortality and population-level survival were identified from secondary data sets for 167 acute hospitals and 34 cancer networks in England. We correlated rankings of networks and hospitals between the data sets using non-parametric statistics. At cancer network level, peer-review service standards were associated (P < 0.05) with 1-year survival for colorectal and lung cancers, and waiting times for lung cancer. At hospital level, standards were associated (P < 0.01) with waiting time to treatment for breast and colorectal cancers. However, there were stronger associations between specializations within hospitals: rankings of breast, colorectal and prostate cancers were highly associated (P < 0.001) for 5-year survival, patient satisfaction, standards and in-hospital mortality. Hospital-level differences appear to contribute more to variations in cancer performance than specialization differences within hospitals. The findings may be used for planning and commissioning better cancer services.

Type: Article
Title: Is the performance of cancer services influenced more by hospital factors or by specialization?
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/pubmed/fdm081
Keywords: cancer services, hospital, management, performance, planning, specialization, BREAST-CANCER, HEALTH-CARE, SURVIVAL, OUTCOMES, IMPROVE, MANAGEMENT, EVALUATE, VOLUME
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Behavioural Science and Health
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Mathematics
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Mathematics > Clinical Operational Research Unit
URI: https://discovery.ucl.ac.uk/id/eprint/5061
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