Comparison of Commission on Cancer-Approved and -Nonapproved Hospitals in the United States: Implications for Studies That Use the National Cancer Data Base
Comparison of Commission on Cancer-Approved and -Nonapproved Hospitals in the United States: Implications for Studies That Use the National Cancer Data Base
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DOI：
10.1200/jco.2008.21.7018
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发表时间：
2009-09-01
影响因子：
45.3
通讯作者：
Ko, Clifford Y.
中科院分区：
文献类型：
--
作者：
Bilimoria, Karl Y.;Bentrem, David J.;Ko, Clifford Y.
背景癌症委员会（CoC）根据提供广泛肿瘤服务和专家的能力来指定癌症项目。所有CoC批准的医院都必须向国家癌症数据库（NCDB）报告他们的癌症诊断，这些医院的癌症诊断约占美国每年诊断的所有新癌症的70%。然而，它是未知的，如何CoC批准的程序与非CoC批准的hospitals.MethodsBy使用美国医院协会年度调查数据库（2006年），CoC批准和非CoC批准的医院进行了比较，就结构特征结果在4，850家确定的医院中，1，412家（29%）是CoC批准的医院，438家（71%）不是CoC批准的医院。CoC批准的医院比例在州一级从怀俄明州的0%到特拉华州的100%不等。与非CoC批准的医院相比，CoC批准的项目更频繁地获得联合委员会的认可，被国家癌症研究所指定为综合癌症中心，并与医学院或住院医师项目有关联（P < .001）。CoC批准的医院不太可能是关键接入医院或位于农村地区（P < .001）。CoC批准的医院拥有更多的床位，每年进行更多的手术（P <0.001）。CoC批准的程序更频繁地提供肿瘤相关的服务，包括筛查计划，化疗和放疗服务，临终关怀/姑息治疗（P < .001）。使用NCDB的研究应在相关时承认这一限制。
BackgroundThe Commission on Cancer (CoC) designates cancer programs on the basis of the ability to provide a wide range of oncologic services and specialists. All CoC-approved hospitals are required to report their cancer diagnoses to the National Cancer Data Base (NCDB), and the cancer diagnoses at these hospitals account for approximately 70% of all new cancers diagnosed in the United States annually. However, it is unknown how CoC-approved programs compare with non-CoC-approved hospitals.MethodsBy using the American Hospital Association Annual Survey Database (2006), CoC-approved and non-CoC-approved hospitals were compared with respect to structural characteristics (ie, accreditations, geography, and oncologic services provided).ResultsOf the 4,850 hospitals identified, 1,412 (29%) were CoC-approved hospitals, and 3,438 (71%) were not CoC-approved hospitals. The proportion of CoC-approved hospitals varied at the state level from 0% in Wyoming to 100% in Delaware. Compared with non-CoC-approved hospitals, CoC-approved programs were more frequently accredited by the Joint Commission, designated as a Comprehensive Cancer Center by the National Cancer Institute, and affiliated with a medical school or residency program (P < .001). CoC-approved hospitals were less likely to be critical access hospitals or located in rural areas (P < .001). CoC-approved hospitals had more total beds and performed more operations per year (P < .001). CoC-approved programs more frequently offered oncology-related services, including screening programs, chemotherapy and radiation therapy services, and hospice/palliative care (P < .001).ConclusionCompared with non-CoC-approved hospitals, CoC-approved hospitals were larger, were more frequently located in urban locations, and had more cancer-related services available to patients. Studies that use the NCDB should acknowledge this limitation when relevant.