Abstract

OLRY DE LABRY LIMA, A.; EPSTEIN, D. M.; GARCIA MOCHON, L.  and  VILLEGAS PORTERO, R.. A comparison of costs and survival in colorectal cancer patients undergoing surgery according to different organizational models. Rev. esp. enferm. dig. [online]. 2007, vol.99, n.11, pp.643-647. ISSN 1130-0108.

Objective: to determine the effectiveness and costs of different organizational models in caring for colorectal cancer patients through either clinical management functional units or traditional clinical services. Method: post-operative and long-term (after 30 days and 5 years) mortality was analyzed according to number of patients undergoing surgery because of colorectal cancer. Mortality was adjusted for patient-related confounding factors. With that purpose a thorough review of the literature was conducted; information obtained was used in a meta-analysis of randomiszd effects. Concerning costs, a literature search was run to describe differences in number of patients per year between hospitals. Results: surgery costs were found to be smaller, and mean hospital stay shorter, in big-sized hospitals. The meta-analysis showed that the risk of death at 30 days and 5 years was lower in big hospitals versus smaller ones (OR: 1.112; 95% CI 0.986-1.255, and OR: 1.114; 95% CI 1.105-1.183, respectively). Conclusions: short- and long-term postoperative mortality is lower in hospitals with a high number of cases per year.

Keywords : Colorectal cancer; Hospital; Volume; Mortality.

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