Comparing survival outcomes for patients with colorectal cancer treated in public and private hospitals.
OBJECTIVE
To determine whether treatment in a private versus public hospital was an independent predictor of survival outcomes in patients with colorectal cancer.


METHODS
Retrospective, population-based study.


METHODS
Tertiary care hospitals.


METHODS
All patients diagnosed with colorectal cancer in Western Australia between 1993 and 2003.


METHODS
Management in private versus public hospitals.


METHODS
Overall survival and cancer-specific survival rates.


RESULTS
5809 patients were treated for colorectal cancer. Of these, 1523 (26%) were managed in private hospitals. The 5-year overall survival rates for private and public hospital patients were 59.4% (95% CI, 56.9%-61.9%) and 48.6% (95% CI, 47.0%-50.2%), respectively. Significant independent predictors of overall survival were: treatment in a private hospital (P = 0.0001; relative risk [RR], 0.764; 95% CI, 0.696-0.839); younger age (P = 0.0001; RR, 1.032; 95% CI, 1.029-1.036); male sex (P = 0.001; RR, 1.148; 95% CI, 1.068-1.234); and cancer stage (eg, Stage II: P = 0.0001; RR, 1.508; 95% CI, 1.316-1.729).


CONCLUSIONS
Treatment in a private hospital was a significant independent predictor of survival outcomes. Further validation of these results would have a significant bearing on how we approach health care delivery for patients with colorectal cancer.
Morris
Melinda
M
School of Surgery and Pathology, University of Western Australia, Perth, WA.
Iacopetta
Barry
B
Platell
Cameron
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D016304:Hospitals, Private; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011159:Population Surveillance; D011379:Prognosis; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D014904:Western Australia / Q000453:epidemiology