For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery

Sen, Sounok; Soulos, Pamela R.; Herrin, Jeph; Roberts, Kenneth B.; Yu, James B.; Lesnikoski, Beth‐Ann; Ross, Joseph S.; Krumholz, Harlan M.; Gross, Cary P.

doi:10.1016/j.surg.2013.12.009

Cited by 8 publications

(4 citation statements)

References 44 publications

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“…In hospitals with for-profit ownership, patients reported significantly more social support from nurses than in public hospitals. However, on the basis of our data, we cannot provide explanations for this result, and results from previous studies concerning associations between hospital ownership and patient care have been inconsistent [23,35]. The fact that significant results are found for ownership only in the third model might be ascribed to the high variance explanation achieved by adding the variables describing process organization.…”

Section: Interpretation Within the Context Of The Wider Literaturecontrasting

confidence: 80%

Hospital Processes and the Nurse-Patient Interaction in Breast Cancer Care. Findings from a Cross-Sectional Study

Lubasch

Lee

Kowalski

et al. 2021

IJERPH

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(1) Background: Evidence suggests that organizational processes of hospitals have an impact on patient-professional interactions. Within the nurse-patient interaction, nurses play a key role providing social support. Factors influencing the nurse-patient interaction have seldomly been researched. We aimed to examine whether the process organization in hospitals is associated with breast cancer patients’ perceived social support from nurses.; (2) Methods: Data analysis based on a cross-sectional patient survey (2979 breast cancer patients, 83 German hospitals) and information on hospital structures. Associations between process organization and perceived social support were analyzed with logistic hierarchical regression models adjusted for patient characteristics and hospital structures.; (3) Results: Most patients were 40–69 years old and classified with UICC stage II or III. Native language, age and hospital ownership status showed significant associations to the perception of social support. Patients treated in hospitals with better process organization at admission (OR 3.61; 95%-CI 1.67, 7.78) and during the hospital stay (OR 2.11; 95%-CI 1.04; 4.29) perceived significantly more social support from nurses.; (4) Conclusions: Designing a supportive nursing work environment and improving process organization in hospitals may create conditions conducive for a supportive patient-nurse interaction. More research is needed to better understand mechanisms behind the associations found.

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Section: Interpretation Within the Context Of The Wider Literaturecontrasting

confidence: 80%

Hospital Processes and the Nurse-Patient Interaction in Breast Cancer Care. Findings from a Cross-Sectional Study

Lubasch

Lee

Kowalski

et al. 2021

IJERPH

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“…Finally, more for‐profit hospitals explained the shorter treatment delays in Kentucky. Recent research has found for‐profit hospitals adopting newer, costly treatments for breast cancers . This finding is consistent with previous research showing for‐profit facilities respond to changes in demand and technology faster than other hospitals.…”

Section: Discussionsupporting

confidence: 88%

Disparities in Colorectal Cancer Treatment Delay Within Appalachia—The Role of For‐Profit Hospitals

Seiber¹,

Camacho

Zeeshan

et al. 2015

The Journal of Rural Health

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Background Appalachian residents have a higher overall cancer burden than the rest of the United States because of the unique features of the region. Treatment delays vary widely within Appalachia, with colorectal cancer patients undergoing median treatment delays of 5 days in Kentucky compared to 9 days for patients in Pennsylvania, Ohio, and North Carolina combined. Objective This study identified the source of this disparity in treatment delay using statistical decomposition techniques. Methodology This study used linked 2006 to 2008 cancer registry and Medicare claims data for the Appalachian counties of Kentucky, Pennsylvania, Ohio, and North Carolina to estimate a 2-part model of treatment delay. An Oaxaca Decomposition of the 2-part model revealed the contribution of the individual determinants to the disparity in delay between Kentucky counties and the remaining 3 states. Results The Oaxaca Decomposition revealed that the higher percentage of patients treated at for-profit facilities in Kentucky proved the key contributor to the observed disparity. In Kentucky, 22.3% patients began their treatment at a for-profit facility compared to 1.4% in the remaining states. Patients initiating treatment at for-profit facilities explained 79% of the observed difference in immediate treatment (<2 days after diagnosis) and 72% of Kentucky’s advantage in log days to treatment. Conclusions The unique role of for-profit facilities led to reduced treatment delay for colorectal cancer patients in Kentucky. However, it remains unknown whether for-profit-hospitals’ more rapid treatment converts to better health outcomes for colorectal cancer patients.

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“…We included hospital referral region-level two year rate of mammogram among female Medicare enrollees age 67–69, divided in quartiles, as this has been shown previously to be associated with receipt of brachytherapy. (21)…”

Section: Methodsmentioning

confidence: 99%

Physician's peer exposure and the adoption of a new cancer treatment modality

Pollack

Soulos

Gross

2015

Cancer

Self Cite

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Background New technologies—often with limited evidence to support their effectiveness—frequently diffuse into clinical practice and increase the costs of cancer care. We studied whether physician peer exposure was associated with the subsequent adoption of a new approach to adjuvant radiation therapy (brachytherapy) for the treatment of women with early stage breast cancer. Methods We performed a retrospective cohort study using SEER-Medicare data. Data from 2003–2004 was used to classify surgeons as early brachytherapy adopters and, among non-early adopters, whether they shared patients with early adopters (peer exposure). Data from 2005–2006 was used to examine whether women were more likely to receive brachytherapy if their surgeons were exposed to early adopters. Results Overall, the proportion of women receiving brachytherapy increased from 3.2% in 2003–2004 to 4.7% in 2005–2006. In this latter period, 2,087 patients were assigned to 328 non-early adopting surgeons. In unadjusted analyses, patients whose surgeons were connected to early adopters during 2003–2004 were significantly more likely to receive brachytherapy in 2005–2006 compared to those whose surgeons were not connected to early adopters (8.0% versus 4.1%, p=0.003). In adjusted analyses, the predicted probability of receiving brachytherapy in patients whose surgeon did have an early adopting peer was 3.9% vs. 1.0% among those whose surgeons did not have an early adopting peer(p=0.03). Conclusions Exposure to peers who were early adopters of brachytherapy was associated with a surgeon’s subsequent uptake of brachytherapy. This study provides an example of a novel approach to examining the diffusion of innovation in cancer care.

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For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery

Cited by 8 publications

References 44 publications

Hospital Processes and the Nurse-Patient Interaction in Breast Cancer Care. Findings from a Cross-Sectional Study

Hospital Processes and the Nurse-Patient Interaction in Breast Cancer Care. Findings from a Cross-Sectional Study

Disparities in Colorectal Cancer Treatment Delay Within Appalachia—The Role of For‐Profit Hospitals

Physician's peer exposure and the adoption of a new cancer treatment modality

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