| ORGANISATIONAL
DETERMINANTS OF PROSTATE CANCER OUTCOMES.
Professor M. McCarthy University College, London |
 |
SUMMARY INTERIM REPORT - June 2006
Professor McCarthy works in public health and this research will look at how the organization of health care within a community affects the outcome in Prostate Cancer. For example, patients diagnosed with prostate cancer will have different survival rates in different parts of the country.
This will be a large demographic study and seeks to answer some important
questions:
i) do organizational factors contribute to prostate cancer survival?
ii) do organizational factors contribute to prostate cancer patients’ view
of their care?
iii) do waiting times correlate with survival or satisfaction?
Professor McCarthy has done some preliminary research which shows that patients in SE London feel they are less well treated than those in Dorset, and waiting times for urgent cancer referrals are nearly twice as long in North Cumbria as they are in NE London.
Read the full Interim Report on this research here (.pdf 20Kb).
SUMMARY FINAL REPORT - January 2007
Professor McCarthy and Dr Datta, at UCL Department of Epidemiology and Public Health, have investigated how hospital characteristics might affect prostate cancer survival and patient satisfaction. They used six national data sets for England relating to the period 2000 - 2006. Outcome measures were 1year and 5year survival, and questions from a patient satisfaction survey. Survival was assessed at the level of the 34 cancer networks in England (each averaging around six hospitals cooperating on cancer services), while satisfaction was measured at hospital trust level.
Comparing outcomes with general hospital measures, the analysis showed higher average survival associated with higher levels of senior hospital medical staffing, yet also with slower hospital general emergency admission times. There was no association between survival, size of hospital, overall hospital spending on cancer chemotherapy, or early (in-hospital) mortality.
Patient satisfaction measured by the question 'Were you treated with respect and dignity during inpatient admission?' was lower in larger hospitals, and in hospitals with longer average waits before for admission.
Hospitals with specialist prostate cancer services appeared to have higher rates of compliance with national cancer services standards than hospitals providing only local services, and (although numbers were small) showed greater associations between standards and satisfaction.
The study indicates the use of multiple measures in assessing the performance of hospitals treating prostate cancer. Future research using longitudinal rather than cross-sectional data, analyses at individual rather than grouped levels, and sufficient numbers of units (hospitals, networks) for strong statistical analysis would contribute further to explaining organisational determinants of prostate cancer outcomes.
Read the full Final Report on this research here (.pdf 275Kb).
Research Project 2005/14 - awarded March 2006