title: Health Services Research and Regionalization of Care-From Policy to Practice: the Ontario Experience in Head and Neck Cancer.
abstract: Patients being treated at higher case volume hospitals or by higher case volume physicians appear to have better outcomes. This volume-outcome relationship is reviewed for oncologic and non-oncologic surgery with a focus on head and neck oncology. The impact of these research findings on health policy and health-care organization in Ontario, Canada, is then outlined. Lastly, future directions for quality improvement in surgical oncology are reviewed in the context of a universal health-care system. These include surgeon report cards, pre-operative checklists, linking funding and remuneration to the quality of delivered care, and the use of process improvement techniques.
authors: Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada. antoine.eskander@mail.utoronto.ca.
authors: Antoine
authors: A
authors: Eskander
authors: Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada. david.goldstein@uhn.ca.|Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. david.goldstein@uhn.ca.
authors: David P
authors: DP
authors: Goldstein
authors: Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada. jonathan.irish@uhn.ca.|Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. jonathan.irish@uhn.ca.|Department of Otolaryngology - Head & Neck Surgery, University Health Network, Princess Margaret Hospital, 610 University Ave., Rm 3-954, Toronto, Ontario, M5G 2M9, Canada. jonathan.irish@uhn.ca.
authors: Jonathan C
authors: JC
authors: Irish
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration / Q000706:statistics & numerical data; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006302:Health Services Research; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data; D006801:Humans; D009864:Ontario; D017063:Outcome Assessment, Health Care
keywords: Clinical epidemiology; Head and neck cancer; Health services research; Hospital volume; Outcomes research; Regionalization; Surgeon volume