TY - JOUR
T1 - The impact of a multi-hospital network on the inequality in odds of receiving resection or ablation for synchronous colorectal liver metastases
AU - van der Ven, Roos G.F.M.
AU - Westra, Daan
AU - van Erning, Felice N.
AU - de Hingh, Ignace H.
AU - Olde Damink, Steven W.M.
AU - Paulus, Agnes
AU - Leclercq, Wouter K.G.
AU - den Dulk, Marcel
AU - OncoZON Consortium
N1 - Funding Information:
R.G.F.M. van der Ven receives partial salary support from the OncoZON consortium for a broader project on network research. All other authors have no disclosures to report. The consortium had no involvement in the study design, collection, analyses and interpretation of data, writing of the report, and in the decision to submit the article for publication. No potential conflict of interest was reported by the author(s).
Publisher Copyright:
© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023/8/3
Y1 - 2023/8/3
N2 - 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.
AB - 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.
KW - centralized hospital services
KW - colorectal neoplasms
KW - health services accessibility
KW - Healthcare disparities
KW - multi-institutional systems
KW - neoplasm metastasis
U2 - 10.1080/0284186X.2023.2238545
DO - 10.1080/0284186X.2023.2238545
M3 - Article
C2 - 37548150
SN - 0284-186X
VL - 62
SP - 842
EP - 852
JO - Acta Oncologica
JF - Acta Oncologica
IS - 8
ER -