INSTITUTIONAL DETERMINANTS OF VARIABILITY OF CARE

这项调查的具体目的是确定地理， 护理模式的时间和机构相关性;评估 护理模式的差异与地理 位置;以确定治疗结果与 体制因素;确定治疗结果是否因地区而异 对于具有相似疾病特征的患者。 这项研究将是 根据美国大学收集的可用数据， 外科医生（ACOS）护理模式研究。 ACOS的先前研究 调查显示，治疗方法和生存率的变化， 时间 医疗模式的机构和地理相关性还没有得到证实。 接受调查 这些信息将有助于未来的癌症控制 针对患者护理和结果的项目。 的变化 护理模式将通过使用方差分析来确定， 回归和生存分析。 此外，ACOS数据集将 与代表该地区所有医院的医院特征相比， 美国通过美国医院协会的数据和患者 将特征与监测流行病学和结束 可比性结果数据。 这项研究的结果将有助于 改善保健服务提供过程。 此外，调查结果 这项研究将突出未来研究的领域， 护理模式和这种护理的传播。

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.