Author Interviews, Cancer Research, Health Care Systems, JAMA, Outcomes & Safety, Surgical Research, Yale / 12.04.2019
Surgical Outcomes Found to be Better at ‘Brand Name’ than Affiliate Cancer Hospitals
MedicalResearch.com Interview with:
[caption id="attachment_48489" align="alignleft" width="133"] Dr. Boffa[/caption]
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.
Dr. Boffa[/caption]
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.
Dr. Rivera Hernandez[/caption]
Maricruz Rivera-Hernandez, PhD
Investigator
Department of Health Services, Policy & Practice
Center for Gerontology and Health Care Research
Brown University, Providence, RI
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Rivera-Hernandez: Over three-quarters of Medicare-eligible residents in Puerto Rico enroll in Medicare Advantage plans, making them the primary source of health care coverage for the island’s seniors. Puerto Rican Medicare Advantage plans have a long history of receiving lower payments than Medicare Advantage plans located in the United States.
The study’s purpose was to compare the quality of care provided to Medicare Advantage enrollees in Puerto Rico with that delivered to Medicare Advantage enrollees in the 50 states and the District of Columbia.
We found significantly worse quality for Puerto Rican Medicare Advantage enrollees compared to their US counterparts for 15 of the 17 quality indicators. These indicators measured whether patients received the recommended treatment and achieved desired outcomes in diabetes care, cardiovascular disease, and cancer screening and whether they received any inappropriate medications in 2011.