Quality of pancreatic cancer care at Veterans Administration compared with non-Veterans Administration hospitals

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• 作者：Karl Y. Bilimoria ; David J. Bentrem ; James S. Tomlinson ; Ryan P. Merkow ; Andrew K. Stewart ; Clifford Y. Ko ; Jay B. Prystowsky ; Mark S. Talamonti
• 关键词：National Cancer Data Base ; Pancreatectomy ; Pancreatic neoplasms ; Surgery ; Veterans Administration Medical Center
• 刊名：The American Journal of Surgery
• 出版年：2007
• 期刊代码：9_00029610
• 类别：med
• 出版时间：November 2007
• 卷：194
• 期：5
• 页码：588-593
• 文件大小：100 K

摘要

National efforts are underway to monitor the quality of patient care at Veterans Administration (VA) hospitals. The objective of this study was to examine treatment utilization and outcomes for localized pancreatic cancer at VA compared with non-VA hospitals.

ss="h4">Methods

Using the National Cancer Data Base, patients with pretreatment clinical stage I/II pancreatic adenocarcinoma were identified. Treatment utilization and outcomes were assessed at VA compared with academic and community hospitals.

ss="h4">Results

Of 35,009 patients, 2%were seen at VA, 38%at academic, and 54%at community hospitals. VA hospitals were more likely to use surgery (odds ratio 2.20, 95%confidence interval 1.73–2.79) and to administer adjuvant chemotherapy (odds ratio 1.77, confidence interval 1.28–2.46) compared with community hospitals. Adjusted perioperative mortality and 3-year survival rates after surgery were similar at VA and academic hospitals.

ss="h4">Conclusions

For localized pancreatic cancer, patients treated at VA hospitals receive stage-specific treatments and have risk-adjusted perioperative and long-term survival rates that are comparable with those for patients treated at academic centers.