INSTITUTIONAL DETERMINANTS OF VARIABILITY OF CARE

这次调查的具体目的是确定地理位置， 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相关的程度 地点；以确定治疗结果与 制度性因素；确定治疗结果是否因地区而不同 适用于有相似疾病特征的患者。这项研究将是 基于通过美国大学学院收集的现有数据 外科医生(ACOS)护理模式研究。美国儿科学会之前的研究 调查显示，在过去的几年中，治疗方法和存活率存在差异 时间到了。护理模式的机构和地理相关性尚未得到证实 接受调查。这些信息将有助于未来的癌症控制 针对病人护理和结果的项目。变化中的 护理模式将通过使用方差分析来确定， 回归分析和生存分析。此外，ACOS数据集将是 与代表全市所有医院的医院特色相比 美国通过美国医院协会的数据和患者 特征将与监测流行病学进行比较，并结束 结果数据具有可比性。这项研究的结果将有助于 改进提供保健服务的过程。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.