INSTITUTIONAL DETERMINANTS OF VARIABILITY OF CARE

这次调查的具体目的是确定地理，

The specific aims of this investigation are to determine the geographic, temporal and institutional correlates of patterns-of-care; to assess the degree to which differences in patterns-of-care relate to geographic location; to determine the association of treatment outcomes to institutional factors; to determine if treatment outcomes differ regionally for patients with similar disease characteristics. This research will be based upon available data gathered through the American College of Surgeons' (ACOS) patterns-of-care studies. Previous studies from the ACOS surveys have shown variations in treatment practices and survival over time. Institutional and geographic correlates of patterns-of-care are yet to be investigated. Such information will aid in future cancer control projects directed at patient care and outcome. Variations in patterns-of-care will be determined through use of analysis of variance, regression and survival analyses. In addition, the ACOS data set will be compared to hospital characteristics representative of all hospitals in the United States through American Hospital Association data and patient characteristics will be compared to the Surveillance Epidemiology and End Results data for comparability. The results of this research will aid in improvements in the process of health care delivery. Furthermore, findings from this study will highlight areas for future research in patterns-of-care and the diffusion of such care.