title: [A comparison of costs and survival in colorectal cancer patients undergoing surgery according to different organizational models].
abstract: 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.
  
  
  METHODS
  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 randomized 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.
authors.affiliation: Escuela Andaluza de Salud Pública, Campus Universitario de Cartuja, Granada. antonio.olry-labry.easp@juntadeandalucia.es
authors.forename: A
authors.initials: A
authors.lastname: Olry de Labry Lima
authors.forename: D M
authors.initials: DM
authors.lastname: Epstein
authors.forename: L
authors.initials: L
authors.lastname: García Mochón
authors.forename: R
authors.initials: R
authors.lastname: Villegas Portero
mesh_terms: D015179:Colorectal Neoplasms / Q000191:economics* / Q000401:mortality* / Q000601:surgery; D003365:Costs and Cost Analysis; D006276:Health Facility Size; D006801:Humans; D017146:Models, Organizational; D016019:Survival Analysis