Are hospitals in Japan with larger patient volume treating younger and earlier-stage cancer patients? An analysis of hospital-based cancer registry data in Japan

Tsukada, Yoichiro; Nakamura, Fumiaki; Iwamoto, Momoko; Nishimoto, Hiroshi; Emori, Yoshiko; Terahara, Atsuro; Higashi, Takahiro

doi:10.1093/jjco/hyv069

Cited by 8 publications

(11 citation statements)

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“…The median age of patients varied among countries from 63 to 70 years, and the Taiwanese study population was notable in having the lowest proportion of men and current or former smokers, perhaps because of variability in attendance at study sites or possible selection bias. Tsukada and coworkers [ 37 ] studied the characteristics of cancer populations among different types of hospitals in Japan, and they found higher proportions of early-stage cancer and younger patients at higher-volume hospitals than at lower-volume hospitals. Substantial variations in patterns of care for NSCLC among the different hospital types were recorded in their study in Japan [ 37 ], as well as in prior observational studies in Taiwan [ 38 ] and the Netherlands [ 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Health care resource use among patients with advanced non-small cell lung cancer: the PIvOTAL retrospective observational study

Lee

Isobe

Wirtz

et al. 2018

BMC Health Serv Res

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BackgroundData are scarce regarding real-world health care resource use (HCRU) for non-small cell lung cancer (NSCLC). An understanding of current clinical practices and HCRU is needed to provide a benchmark for rapidly evolving NSCLC management recommendations and therapeutic options. The objective of this study was to describe real-world HCRU for patients with advanced NSCLC.MethodsThis multinational, retrospective chart review study was conducted at academic and community oncology sites in Italy, Spain, Germany, Australia, Japan, South Korea, Taiwan, and Brazil. Deidentified data were drawn from medical records of 1440 adults (≥18 years old) who initiated systemic therapy (2011 to mid-2013) for a new, confirmed diagnosis of advanced or metastatic (stage IIIB or IV) NSCLC. We summarized HCRU associated with first and subsequent lines of systemic therapy for advanced/metastatic NSCLC.ResultsThe proportion of patients who were hospitalized at least once varied by country from 24% in Italy to 81% in Japan during first-line therapy and from 22% in Italy to 84% in Japan during second-line therapy; overall hospitalization frequency was 2.5–11.1 per 100 patient-weeks, depending on country. Emergency visit frequency also varied among countries (overall from 0.3–5.9 per 100 patient-weeks), increasing consistently from first- through third-line therapy in each country. The outpatient setting was the most common setting of resource use. Most patients in the study had multiple outpatient visits in association with each line of therapy (overall from 21.1 to 59.0 outpatient visits per 100 patient-weeks, depending on country). The use of health care resources showed no regular pattern associated with results of tests for activating mutations of the epidermal growth factor receptor (EGFR) gene or anaplastic lymphoma kinase (ALK) gene rearrangements.ConclusionsHCRU varied across countries. These findings suggest differing approaches to the clinical management of advanced NSCLC among the eight countries. Comparative findings and an understanding of country-specific clinical practices can help to identify areas of need and guide future resource allocation for patients with advanced NSCLC. Further studies evaluating the costs associated with resource use are warranted.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-2946-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Health care resource use among patients with advanced non-small cell lung cancer: the PIvOTAL retrospective observational study

Lee

Isobe

Wirtz

et al. 2018

BMC Health Serv Res

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“…The remainder were included in the study sample for generating variables for hospital volume. For survival analysis, we excluded those aged 85‐99 years as older age is a critical confounder to the choice of hospital and survival probability. Male breast cancer cases and cases where there was a lack of information regarding the survival status at 5 years from diagnosis or the survival period between the diagnosis and the last observation were excluded from the analysis (Figure ).…”

Section: Methodsmentioning

confidence: 99%

“…Patient outcomes used in previous studies have also varied; these include 5‐year survival, postoperative mortality, procedure‐related complications and recurrence of cancer . Although a number of studies have demonstrated that patients treated at high‐volume hospitals have better outcomes, patient characteristics are critical confounders to the choice of hospital and patient outcomes . In addition, the variation of volume‐outcome relationships may be affected by the clinical rarity and technical complexity of the surgical procedure.…”

Section: Introductionmentioning

confidence: 99%

“…16,22 Although a number of studies have demonstrated that patients treated at high-volume hospitals have better outcomes, patient characteristics are critical confounders to the choice of hospital and patient outcomes. 23,24 In addition, the variation of volume-outcome relationships may be affected by the clinical rarity and technical complexity of the surgical procedure. For instance, rare, complex cancer operations have stronger associations with mortality than common and simple operations.…”

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confidence: 99%

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Hospital volume and postoperative 5‐year survival for five different cancer sites: A population‐based study in Japan

et al. 2020

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The relationship between hospital volume and patient outcome is globally known; thus, hospital volume is widely used as a quality indicator. In Japan, however, recent studies on this topic are scarce. The present study examined whether hospital surgery volume is associated with postoperative 5‐year survival among cancer patients. Using the Osaka Cancer Registry, we identified a sample of 86 145 patients who were diagnosed with cancer at any of five different sites (stomach, colorectum, lung, breast and uterus) and underwent surgeries between 2007 and 2011 in Osaka. We ranked hospitals by annual surgical volume, sorted patients in descending order by hospital volume, and assigned them into quartiles (high, medium, low and very low volume). We analyzed the association between hospital volume and 5‐year survival among 80 959 patients aged between 15 and 84 years using Cox proportional hazard models. Adjustments were made for characteristics of patients, type of surgery and adjuvant treatment received. The mortality hazard of patients treated at very low‐volume hospitals was 1.36‐1.82‐fold higher than that of patients treated at high‐volume hospitals. Absolute differences in adjusted survival rates between high‐volume and very low‐volume hospitals varied with the cancer site: 14.9 in stomach, 11.5 in colorectal, 10.8 in lung, 2.4 in breast and 3.3 in uterine cancers. Hospitals with lower surgery volumes showed higher mortality risks after cancer surgery than those with higher volumes. Monitoring site‐specific surgery volumes and referring patients from low‐volume to high‐volume hospitals may be beneficial for improving the long‐term survival of cancer patients.

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“…The difference in patient survival could also be affected by patient characteristics, because previous studies report that hospital selection is associated with patient characteristics in Japan. 29,30 For example, we observed that the difference in the HR among national, prefectural, and non-DCCHs narrowed after controlling for patient characteristics. A previous study reported that the difference in survival probability among DCCHs was narrowed by adjusting the performance status and comorbidity of patients.…”

Section: Ta B L E 1 (Continued)mentioning

confidence: 79%

Three‐year survival from diagnosis in surgically treated patients in designated and nondesignated cancer care hospitals in Japan

et al. 2021

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Are hospitals in Japan with larger patient volume treating younger and earlier-stage cancer patients? An analysis of hospital-based cancer registry data in Japan

Cited by 8 publications

References 20 publications

Health care resource use among patients with advanced non-small cell lung cancer: the PIvOTAL retrospective observational study

Health care resource use among patients with advanced non-small cell lung cancer: the PIvOTAL retrospective observational study

Hospital volume and postoperative 5‐year survival for five different cancer sites: A population‐based study in Japan

Three‐year survival from diagnosis in surgically treated patients in designated and nondesignated cancer care hospitals in Japan

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