title: Cancer patient experience, hospital performance and case mix: evidence from England.
abstract: OBJECTIVE
  This study aims to explore differences between crude and case mix-adjusted estimates of hospital performance with respect to the experience of cancer patients.
  
  
  METHODS
  This study analyzed the English 2011/2012 Cancer Patient Experience Survey covering all English National Health Service hospitals providing cancer treatment (n = 160). Logistic regression analysis was used to predict hospital performance for each of the 64 evaluative questions, adjusting for age, gender, ethnic group and cancer diagnosis. The degree of reclassification was explored across three categories (bottom 20%, middle 60% and top 20% of hospitals).
  
  
  RESULTS
  There was high concordance between crude and adjusted ranks of hospitals (median Kendall's τ = 0.84; interquartile range: 0.82-0.88). Across all questions, a median of 5.0% (eight) of hospitals (interquartile range: 3.8-6.4%; six to ten hospitals) moved out of the extreme performance categories after case mix adjustment.
  
  
  CONCLUSIONS
  In this context, patient case mix has only a small impact on measured hospital performance for cancer patient experience.
authors.affiliation: Cambridge Centre for Health Services Research, University of Cambridge, Cambridge, UK. ga302@medschl.cam.ac.uk.
authors.forename: Gary A
authors.initials: GA
authors.lastname: Abel
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Saunders
authors.forename: Georgios
authors.initials: G
authors.lastname: Lyratzopoulos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities / Q000592:standards*; D004739:England; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy*; D011785:Quality Assurance, Health Care; D020379:Risk Adjustment; D055815:Young Adult
keywords: cancer; case mix adjustment; disparity; inequality; organizational quality; patient experience; public reporting; satisfaction