Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care
Background Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Bristow, Robert E. [verfasserIn] Puri, Isha [verfasserIn] Diaz-Montes, Teresa P. [verfasserIn] Giuntoli, Robert L. [verfasserIn] Armstrong, Deborah K. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2009 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Annals of surgical oncology - Berlin [u.a.] : Springer, 1994, 16(2009), 12 vom: 27. Aug., Seite 3422-3430 |
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| Übergeordnetes Werk: |
volume:16 ; year:2009 ; number:12 ; day:27 ; month:08 ; pages:3422-3430 |
| Links: |
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| DOI / URN: |
10.1245/s10434-009-0680-5 |
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| Katalog-ID: |
SPR009930361 |
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| 245 | 1 | 0 | |a Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care |
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| 520 | |a Background Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001–2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990–2000. $ χ^{2} $ and logistic regression analyses were used to evaluate for significant trends in case volume distribution over time as well as factors associated with access to high-volume care. Results Overall, 2,475 primary ovarian cancer operations were performed by 472 surgeons at 43 hospitals. There was a statistically significant increase in the proportion of cases performed at high-volume centers from 22.8% in 1990–2000 to 61.1% in 2001–2008 (odds ratio = 5.30, 95% confidence interval = 4.68–6.00, P < .0001), while low-volume hospital case distribution decreased from 49.6 to 31.3%. Access to high-volume surgeons increased from 34.5% in 1990–2000 to 64.5% in 2001–2008 (odds ratio = 3.44, 95% confidence interval = 3.06–3.87, P < .0001), while the proportion of cases performed by low-volume surgeons decreased from 56.3 to 28.9%. After controlling for other variables, high-volume surgeons were significantly more likely to perform ovarian cancer surgery that included hysterectomy and staging/cytoreductive surgical procedures. Conclusions The proportions of ovarian cancer patients undergoing primary surgery at high volume centers and by high-volume surgeons increased statistically significantly from 1990–2000 to 2001–2008. Further investigation is necessary to determine factors contributing to this favorable trend. | ||
| 650 | 4 | |a Ovarian Cancer |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Surgical Care |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Ovarian Cancer Case |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Primary Ovarian Cancer |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Hospital Case Volume |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Puri, Isha |e verfasserin |4 aut | |
| 700 | 1 | |a Diaz-Montes, Teresa P. |e verfasserin |4 aut | |
| 700 | 1 | |a Giuntoli, Robert L. |e verfasserin |4 aut | |
| 700 | 1 | |a Armstrong, Deborah K. |e verfasserin |4 aut | |
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10.1245/s10434-009-0680-5 doi (DE-627)SPR009930361 (SPR)s10434-009-0680-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Bristow, Robert E. verfasserin aut Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001–2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990–2000. $ χ^{2} $ and logistic regression analyses were used to evaluate for significant trends in case volume distribution over time as well as factors associated with access to high-volume care. Results Overall, 2,475 primary ovarian cancer operations were performed by 472 surgeons at 43 hospitals. There was a statistically significant increase in the proportion of cases performed at high-volume centers from 22.8% in 1990–2000 to 61.1% in 2001–2008 (odds ratio = 5.30, 95% confidence interval = 4.68–6.00, P < .0001), while low-volume hospital case distribution decreased from 49.6 to 31.3%. Access to high-volume surgeons increased from 34.5% in 1990–2000 to 64.5% in 2001–2008 (odds ratio = 3.44, 95% confidence interval = 3.06–3.87, P < .0001), while the proportion of cases performed by low-volume surgeons decreased from 56.3 to 28.9%. After controlling for other variables, high-volume surgeons were significantly more likely to perform ovarian cancer surgery that included hysterectomy and staging/cytoreductive surgical procedures. Conclusions The proportions of ovarian cancer patients undergoing primary surgery at high volume centers and by high-volume surgeons increased statistically significantly from 1990–2000 to 2001–2008. Further investigation is necessary to determine factors contributing to this favorable trend. Ovarian Cancer (dpeaa)DE-He213 Surgical Care (dpeaa)DE-He213 Ovarian Cancer Case (dpeaa)DE-He213 Primary Ovarian Cancer (dpeaa)DE-He213 Hospital Case Volume (dpeaa)DE-He213 Puri, Isha verfasserin aut Diaz-Montes, Teresa P. verfasserin aut Giuntoli, Robert L. verfasserin aut Armstrong, Deborah K. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 16(2009), 12 vom: 27. Aug., Seite 3422-3430 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:16 year:2009 number:12 day:27 month:08 pages:3422-3430 https://dx.doi.org/10.1245/s10434-009-0680-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 16 2009 12 27 08 3422-3430 |
| spelling |
10.1245/s10434-009-0680-5 doi (DE-627)SPR009930361 (SPR)s10434-009-0680-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Bristow, Robert E. verfasserin aut Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001–2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990–2000. $ χ^{2} $ and logistic regression analyses were used to evaluate for significant trends in case volume distribution over time as well as factors associated with access to high-volume care. Results Overall, 2,475 primary ovarian cancer operations were performed by 472 surgeons at 43 hospitals. There was a statistically significant increase in the proportion of cases performed at high-volume centers from 22.8% in 1990–2000 to 61.1% in 2001–2008 (odds ratio = 5.30, 95% confidence interval = 4.68–6.00, P < .0001), while low-volume hospital case distribution decreased from 49.6 to 31.3%. Access to high-volume surgeons increased from 34.5% in 1990–2000 to 64.5% in 2001–2008 (odds ratio = 3.44, 95% confidence interval = 3.06–3.87, P < .0001), while the proportion of cases performed by low-volume surgeons decreased from 56.3 to 28.9%. After controlling for other variables, high-volume surgeons were significantly more likely to perform ovarian cancer surgery that included hysterectomy and staging/cytoreductive surgical procedures. Conclusions The proportions of ovarian cancer patients undergoing primary surgery at high volume centers and by high-volume surgeons increased statistically significantly from 1990–2000 to 2001–2008. Further investigation is necessary to determine factors contributing to this favorable trend. Ovarian Cancer (dpeaa)DE-He213 Surgical Care (dpeaa)DE-He213 Ovarian Cancer Case (dpeaa)DE-He213 Primary Ovarian Cancer (dpeaa)DE-He213 Hospital Case Volume (dpeaa)DE-He213 Puri, Isha verfasserin aut Diaz-Montes, Teresa P. verfasserin aut Giuntoli, Robert L. verfasserin aut Armstrong, Deborah K. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 16(2009), 12 vom: 27. Aug., Seite 3422-3430 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:16 year:2009 number:12 day:27 month:08 pages:3422-3430 https://dx.doi.org/10.1245/s10434-009-0680-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 16 2009 12 27 08 3422-3430 |
| allfields_unstemmed |
10.1245/s10434-009-0680-5 doi (DE-627)SPR009930361 (SPR)s10434-009-0680-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Bristow, Robert E. verfasserin aut Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001–2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990–2000. $ χ^{2} $ and logistic regression analyses were used to evaluate for significant trends in case volume distribution over time as well as factors associated with access to high-volume care. Results Overall, 2,475 primary ovarian cancer operations were performed by 472 surgeons at 43 hospitals. There was a statistically significant increase in the proportion of cases performed at high-volume centers from 22.8% in 1990–2000 to 61.1% in 2001–2008 (odds ratio = 5.30, 95% confidence interval = 4.68–6.00, P < .0001), while low-volume hospital case distribution decreased from 49.6 to 31.3%. Access to high-volume surgeons increased from 34.5% in 1990–2000 to 64.5% in 2001–2008 (odds ratio = 3.44, 95% confidence interval = 3.06–3.87, P < .0001), while the proportion of cases performed by low-volume surgeons decreased from 56.3 to 28.9%. After controlling for other variables, high-volume surgeons were significantly more likely to perform ovarian cancer surgery that included hysterectomy and staging/cytoreductive surgical procedures. Conclusions The proportions of ovarian cancer patients undergoing primary surgery at high volume centers and by high-volume surgeons increased statistically significantly from 1990–2000 to 2001–2008. Further investigation is necessary to determine factors contributing to this favorable trend. Ovarian Cancer (dpeaa)DE-He213 Surgical Care (dpeaa)DE-He213 Ovarian Cancer Case (dpeaa)DE-He213 Primary Ovarian Cancer (dpeaa)DE-He213 Hospital Case Volume (dpeaa)DE-He213 Puri, Isha verfasserin aut Diaz-Montes, Teresa P. verfasserin aut Giuntoli, Robert L. verfasserin aut Armstrong, Deborah K. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 16(2009), 12 vom: 27. Aug., Seite 3422-3430 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:16 year:2009 number:12 day:27 month:08 pages:3422-3430 https://dx.doi.org/10.1245/s10434-009-0680-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 16 2009 12 27 08 3422-3430 |
| allfieldsGer |
10.1245/s10434-009-0680-5 doi (DE-627)SPR009930361 (SPR)s10434-009-0680-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Bristow, Robert E. verfasserin aut Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001–2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990–2000. $ χ^{2} $ and logistic regression analyses were used to evaluate for significant trends in case volume distribution over time as well as factors associated with access to high-volume care. Results Overall, 2,475 primary ovarian cancer operations were performed by 472 surgeons at 43 hospitals. There was a statistically significant increase in the proportion of cases performed at high-volume centers from 22.8% in 1990–2000 to 61.1% in 2001–2008 (odds ratio = 5.30, 95% confidence interval = 4.68–6.00, P < .0001), while low-volume hospital case distribution decreased from 49.6 to 31.3%. Access to high-volume surgeons increased from 34.5% in 1990–2000 to 64.5% in 2001–2008 (odds ratio = 3.44, 95% confidence interval = 3.06–3.87, P < .0001), while the proportion of cases performed by low-volume surgeons decreased from 56.3 to 28.9%. After controlling for other variables, high-volume surgeons were significantly more likely to perform ovarian cancer surgery that included hysterectomy and staging/cytoreductive surgical procedures. Conclusions The proportions of ovarian cancer patients undergoing primary surgery at high volume centers and by high-volume surgeons increased statistically significantly from 1990–2000 to 2001–2008. Further investigation is necessary to determine factors contributing to this favorable trend. Ovarian Cancer (dpeaa)DE-He213 Surgical Care (dpeaa)DE-He213 Ovarian Cancer Case (dpeaa)DE-He213 Primary Ovarian Cancer (dpeaa)DE-He213 Hospital Case Volume (dpeaa)DE-He213 Puri, Isha verfasserin aut Diaz-Montes, Teresa P. verfasserin aut Giuntoli, Robert L. verfasserin aut Armstrong, Deborah K. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 16(2009), 12 vom: 27. Aug., Seite 3422-3430 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:16 year:2009 number:12 day:27 month:08 pages:3422-3430 https://dx.doi.org/10.1245/s10434-009-0680-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 16 2009 12 27 08 3422-3430 |
| allfieldsSound |
10.1245/s10434-009-0680-5 doi (DE-627)SPR009930361 (SPR)s10434-009-0680-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.81 bkl 44.65 bkl Bristow, Robert E. verfasserin aut Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care 2009 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001–2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990–2000. $ χ^{2} $ and logistic regression analyses were used to evaluate for significant trends in case volume distribution over time as well as factors associated with access to high-volume care. Results Overall, 2,475 primary ovarian cancer operations were performed by 472 surgeons at 43 hospitals. There was a statistically significant increase in the proportion of cases performed at high-volume centers from 22.8% in 1990–2000 to 61.1% in 2001–2008 (odds ratio = 5.30, 95% confidence interval = 4.68–6.00, P < .0001), while low-volume hospital case distribution decreased from 49.6 to 31.3%. Access to high-volume surgeons increased from 34.5% in 1990–2000 to 64.5% in 2001–2008 (odds ratio = 3.44, 95% confidence interval = 3.06–3.87, P < .0001), while the proportion of cases performed by low-volume surgeons decreased from 56.3 to 28.9%. After controlling for other variables, high-volume surgeons were significantly more likely to perform ovarian cancer surgery that included hysterectomy and staging/cytoreductive surgical procedures. Conclusions The proportions of ovarian cancer patients undergoing primary surgery at high volume centers and by high-volume surgeons increased statistically significantly from 1990–2000 to 2001–2008. Further investigation is necessary to determine factors contributing to this favorable trend. Ovarian Cancer (dpeaa)DE-He213 Surgical Care (dpeaa)DE-He213 Ovarian Cancer Case (dpeaa)DE-He213 Primary Ovarian Cancer (dpeaa)DE-He213 Hospital Case Volume (dpeaa)DE-He213 Puri, Isha verfasserin aut Diaz-Montes, Teresa P. verfasserin aut Giuntoli, Robert L. verfasserin aut Armstrong, Deborah K. verfasserin aut Enthalten in Annals of surgical oncology Berlin [u.a.] : Springer, 1994 16(2009), 12 vom: 27. Aug., Seite 3422-3430 (DE-627)343969947 (DE-600)2074021-9 1534-4681 nnns volume:16 year:2009 number:12 day:27 month:08 pages:3422-3430 https://dx.doi.org/10.1245/s10434-009-0680-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.81 ASE 44.65 ASE AR 16 2009 12 27 08 3422-3430 |
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English |
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Enthalten in Annals of surgical oncology 16(2009), 12 vom: 27. Aug., Seite 3422-3430 volume:16 year:2009 number:12 day:27 month:08 pages:3422-3430 |
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Enthalten in Annals of surgical oncology 16(2009), 12 vom: 27. Aug., Seite 3422-3430 volume:16 year:2009 number:12 day:27 month:08 pages:3422-3430 |
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Ovarian Cancer Surgical Care Ovarian Cancer Case Primary Ovarian Cancer Hospital Case Volume |
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Bristow, Robert E. @@aut@@ Puri, Isha @@aut@@ Diaz-Montes, Teresa P. @@aut@@ Giuntoli, Robert L. @@aut@@ Armstrong, Deborah K. @@aut@@ |
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However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001–2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990–2000. $ χ^{2} $ and logistic regression analyses were used to evaluate for significant trends in case volume distribution over time as well as factors associated with access to high-volume care. Results Overall, 2,475 primary ovarian cancer operations were performed by 472 surgeons at 43 hospitals. There was a statistically significant increase in the proportion of cases performed at high-volume centers from 22.8% in 1990–2000 to 61.1% in 2001–2008 (odds ratio = 5.30, 95% confidence interval = 4.68–6.00, P < .0001), while low-volume hospital case distribution decreased from 49.6 to 31.3%. Access to high-volume surgeons increased from 34.5% in 1990–2000 to 64.5% in 2001–2008 (odds ratio = 3.44, 95% confidence interval = 3.06–3.87, P < .0001), while the proportion of cases performed by low-volume surgeons decreased from 56.3 to 28.9%. After controlling for other variables, high-volume surgeons were significantly more likely to perform ovarian cancer surgery that included hysterectomy and staging/cytoreductive surgical procedures. Conclusions The proportions of ovarian cancer patients undergoing primary surgery at high volume centers and by high-volume surgeons increased statistically significantly from 1990–2000 to 2001–2008. 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Bristow, Robert E. |
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Bristow, Robert E. ddc 610 bkl 44.81 bkl 44.65 misc Ovarian Cancer misc Surgical Care misc Ovarian Cancer Case misc Primary Ovarian Cancer misc Hospital Case Volume Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care |
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610 ASE 44.81 bkl 44.65 bkl Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care Ovarian Cancer (dpeaa)DE-He213 Surgical Care (dpeaa)DE-He213 Ovarian Cancer Case (dpeaa)DE-He213 Primary Ovarian Cancer (dpeaa)DE-He213 Hospital Case Volume (dpeaa)DE-He213 |
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Bristow, Robert E. Puri, Isha Diaz-Montes, Teresa P. Giuntoli, Robert L. Armstrong, Deborah K. |
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analysis of contemporary trends in access to high-volume ovarian cancer surgical care |
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Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care |
| abstract |
Background Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001–2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990–2000. $ χ^{2} $ and logistic regression analyses were used to evaluate for significant trends in case volume distribution over time as well as factors associated with access to high-volume care. Results Overall, 2,475 primary ovarian cancer operations were performed by 472 surgeons at 43 hospitals. There was a statistically significant increase in the proportion of cases performed at high-volume centers from 22.8% in 1990–2000 to 61.1% in 2001–2008 (odds ratio = 5.30, 95% confidence interval = 4.68–6.00, P < .0001), while low-volume hospital case distribution decreased from 49.6 to 31.3%. Access to high-volume surgeons increased from 34.5% in 1990–2000 to 64.5% in 2001–2008 (odds ratio = 3.44, 95% confidence interval = 3.06–3.87, P < .0001), while the proportion of cases performed by low-volume surgeons decreased from 56.3 to 28.9%. After controlling for other variables, high-volume surgeons were significantly more likely to perform ovarian cancer surgery that included hysterectomy and staging/cytoreductive surgical procedures. Conclusions The proportions of ovarian cancer patients undergoing primary surgery at high volume centers and by high-volume surgeons increased statistically significantly from 1990–2000 to 2001–2008. Further investigation is necessary to determine factors contributing to this favorable trend. |
| abstractGer |
Background Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001–2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990–2000. $ χ^{2} $ and logistic regression analyses were used to evaluate for significant trends in case volume distribution over time as well as factors associated with access to high-volume care. Results Overall, 2,475 primary ovarian cancer operations were performed by 472 surgeons at 43 hospitals. There was a statistically significant increase in the proportion of cases performed at high-volume centers from 22.8% in 1990–2000 to 61.1% in 2001–2008 (odds ratio = 5.30, 95% confidence interval = 4.68–6.00, P < .0001), while low-volume hospital case distribution decreased from 49.6 to 31.3%. Access to high-volume surgeons increased from 34.5% in 1990–2000 to 64.5% in 2001–2008 (odds ratio = 3.44, 95% confidence interval = 3.06–3.87, P < .0001), while the proportion of cases performed by low-volume surgeons decreased from 56.3 to 28.9%. After controlling for other variables, high-volume surgeons were significantly more likely to perform ovarian cancer surgery that included hysterectomy and staging/cytoreductive surgical procedures. Conclusions The proportions of ovarian cancer patients undergoing primary surgery at high volume centers and by high-volume surgeons increased statistically significantly from 1990–2000 to 2001–2008. Further investigation is necessary to determine factors contributing to this favorable trend. |
| abstract_unstemmed |
Background Positive volume-outcome relationships exist for cancers treated with technically complex surgery, including ovarian cancer. However, contemporary patterns of primary surgical care for ovarian cancer according to hospital and surgeon case volume remain poorly defined. Methods The Maryland Health Service Cost Review Commission database was accessed for annual hospital and surgeon primary ovarian cancer surgical case volume for 2001–2008 and evaluated for statistically significant trends in access to high-volume surgical care compared with the earlier period for 1990–2000. $ χ^{2} $ and logistic regression analyses were used to evaluate for significant trends in case volume distribution over time as well as factors associated with access to high-volume care. Results Overall, 2,475 primary ovarian cancer operations were performed by 472 surgeons at 43 hospitals. There was a statistically significant increase in the proportion of cases performed at high-volume centers from 22.8% in 1990–2000 to 61.1% in 2001–2008 (odds ratio = 5.30, 95% confidence interval = 4.68–6.00, P < .0001), while low-volume hospital case distribution decreased from 49.6 to 31.3%. Access to high-volume surgeons increased from 34.5% in 1990–2000 to 64.5% in 2001–2008 (odds ratio = 3.44, 95% confidence interval = 3.06–3.87, P < .0001), while the proportion of cases performed by low-volume surgeons decreased from 56.3 to 28.9%. After controlling for other variables, high-volume surgeons were significantly more likely to perform ovarian cancer surgery that included hysterectomy and staging/cytoreductive surgical procedures. Conclusions The proportions of ovarian cancer patients undergoing primary surgery at high volume centers and by high-volume surgeons increased statistically significantly from 1990–2000 to 2001–2008. Further investigation is necessary to determine factors contributing to this favorable trend. |
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Analysis of Contemporary Trends in Access to High-Volume Ovarian Cancer Surgical Care |
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| score |
7.3982153 |