MedicalResearch.com Interview with:
Daniel J. Boffa, MD
Associate Professor of Thoracic Surgery
Yale School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Prominent cancer hospitals have been sharing their brands with smaller hospitals in the community. We conducted a series of nationally representative surveys and found that a significant proportion of the U.S. public assumes that the safety of care is the same at all hospitals that share the same respected brand. In an effort to determine if safety was in fact the same, we examined complex surgical procedures in the Medicare database.
We compared the chance of dying within 90 days of surgery between top-ranked hospitals, and the affiliate hospitals that share their brands. When taking into account differences in patient age, health, and type of procedure, Medicare patients were 1.4 times more likely to die after surgery at the affiliate hospitals, compared to those having surgery at the top-ranked cancer hospitals.
MedicalResearch.com: What should readers take away from your report?
Response: Overall, complex cancer surgery appears to be safer at top-ranked cancer hospitals compared to the hospitals that share their prestigious brands. Not every patient would have the desire or means to travel for care at a top-ranked cancer hospital. However, patients should be aware of these differences, and consider them alongside their other care priorities.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Perhaps the most exciting part of this study is the potential to share what is working well at the top-ranked hospitals with other hospitals in their network. The fact that these hospitals are already connected to each other removes a number of important barriers to change.
MedicalResearch.com: Is there anything else you would like to add?
Response: These results characterize care in general, and do not apply to every affiliate and every top-ranked hospital. These results should not be interpreted as affiliates as being unsafe, as many affiliates are safer than the national average, and a couple are even safer than the top-ranked hospital whose brand they share. Hospitals should recognize the potential for patients to assume that brand sharing equates to care equality. Leading cancer hospitals should examine outcomes within their networks and attempt to optimize care across all hospitals environments that share their trusted brand.
No disclosures relevant to this work
Differential Safety Between Top Ranked Cancer Hospitals and Their Affiliates for Complex Cancer Surgery JAMA Open Network DOI: 1001/jamanetworkopen.2019.1912
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