title: Factors influencing the selection of a hospital for colon cancer surgery in Japan: analysis of the effects of surgery volume, hospital functions, and geographic conditions.
abstract: OBJECTIVE
  To identify factors influencing the hospital choice of patients who undergo colon cancer surgery.
  
  
  METHODS
  We conducted a multivariate analysis using micro data from the Patient Survey and the Survey of Medical Institutions conducted by the Statistics and Information Department, Minister's Secretariat, Ministry of Health, Labour and Welfare of Japan, to identify patient and hospital characteristics which influence a patient's decision whether to undergo surgery at a hospital where many colon surgeries have been performed ("high-volume hospital").
  
  
  RESULTS
  Hospitalizations to high-volume hospitals were linked to factors such as referral from nonmedical facilities and the fact that the medical institution was a teaching hospital. Hospitalizations to high-volume hospitals decreased by about 8% for every 1-km increase in distance to the nearest high-volume hospital.
  
  
  CONCLUSIONS
  Geographic factors and hospital function had an impact on admission to high-volume hospitals that are expected to contribute to functionalization of medical institutions and improvement of medical standards. This suggests that geographic conditions should be considered in planning regional coordination systems for specialized medical care.
authors.affiliation: Health Care Informatics, Department of Health Science Policies, Tokyo Medical and Dental University Graduate School. nyoshci@tmd.ac.jp
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Yoshii
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fushimi
mesh_terms: D000368:Aged; D006348:Cardiac Surgical Procedures; D002755:Choice Behavior; D003110:Colonic Neoplasms / Q000601:surgery*; D003325:Coronary Care Units; D004636:Emergency Service, Hospital; D005260:Female; D006742:Hospital Bed Capacity; D015285:Hospital-Patient Relations; D006760:Hospitalization; D006761:Hospitals; D006784:Hospitals, Teaching; D006801:Humans; D007362:Intensive Care Units; D007564:Japan; D007902:Length of Stay; D008297:Male; D010343:Patient Admission; D010351:Patient Discharge; D057240:Patient Preference; D011365:Professional Practice Location; D011872:Radiology Department, Hospital; D012017:Referral and Consultation; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D016896:Treatment Outcome