Interhospital differences in cancer survival: magnitude and trend in 1975-1987 in Osaka, Japan.
This study addresses the disparity in cancer survival rates among hospitals in Osaka, Japan. Using data from the Osaka Cancer Registry, four-year survival rates for stomach cancer patients (n = 8,845) diagnosed in 1976, 1981 and 1986, and lung cancer (n = 9,795) and breast cancer patients (n = 7,377) diagnosed in 1975-77, 1980-82 and 1985-87 were calculated according to four hospital categories (teaching hospitals, large hospitals: 400 + beds excluding teaching hospitals, medium-size hospitals: 150-399 beds, and small hospitals: 20-149 beds). Cox's proportional hazards model was employed with adjustment for sex, age, clinical stage at diagnosis, and treatment status. Stomach and lung cancer patients treated in large, medium-size and small hospitals showed significantly higher risks of death than those treated in teaching hospitals in 1975-87. Interhospital differences in breast cancer survival appeared to increase in 1975-87, whereas those in stomach and lung cancer survivals decreased during the same period.
Tanaka
H
H
Department of Field Research, Center for Adult Diseases, Osaka.
Hiyama
T
T
Hanai
A
A
Fujimoto
I
I
D001943:Breast Neoplasms / Q000401:mortality; D005260:Female; D006744:Hospital Bed Capacity, 100 to 299; D006745:Hospital Bed Capacity, 300 to 499; D006743:Hospital Bed Capacity, under 100; D006761:Hospitals; D006784:Hospitals, Teaching; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D009369:Neoplasms / Q000401:mortality*; D013274:Stomach Neoplasms / Q000401:mortality; D015996:Survival Rate