ArticleBMC health services research2009
Changes in and predictors of length of stay in hospital after surgery for breast cancer between 1997/98 and 2004/05 in two regions of England: a population-based study.
Article in BMC health services research, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interrelationships between Dietary Outcomes, Readmission Rates and Length of Stay in Hospitalised Oncology Patients: A Scoping Review.Nutrients · 2023Pooled it
- Factors Associated with Prolonged Hospitalisation in Women with Breast Cancer: Evidence from a Large German Multicentre Study.Clinics and practice · 2026Article
- Healthcare costs and health outcomes analysis of neoadjuvant Trastuzumab therapy for human epidermal growth factor receptor 2 (HER2) positive breast cancer.Cancer pathogenesis and therapy · 2026Article
- Assessing the performance of non-specialised private hospitals in Malaysia - an upper-middle-income medical tourism destination country using the Pabón-Lasso model.BMC health services research · 2024Article
- The impact of inpatient bed capacity on length of stay.The European journal of health economics : HEPAC : health economics in prevention and care · 2022Article
- Differences in Time Burden across Local Therapy Strategies for Early-stage Breast Cancer.Plastic and reconstructive surgery. Global open · 2021Article
- Factors Affecting the Postsurgical Length of Hospital Stay in Patients with Breast Cancer.The journal of breast health · 2015Article
- Two indicators of hospital resource efficiency in cancer care.Current oncology (Toronto, Ont.) · 2014Article
- Rates of breast cancer surgery in Canada from 2007/08 to 2009/10: retrospective cohort study.CMAJ open · 2014Article
- Analysis of HIV/AIDS DRG in Portugal: a hierarchical finite mixture model.The European journal of health economics : HEPAC : health economics in prevention and care · 2013Article
- Factors predicting hospital length-of-stay after radical prostatectomy: a population-based study.BMC health services research · 2013Article
- Factors predicting hospital length-of-stay and readmission after colorectal resection: a population-based study of elective and emergency admissions.BMC health services research · 2012Article
- Increasing Hospitalization Rates for Cirrhosis: Overrepresentation of Disadvantaged Australians.EClinicalMedicineArticle
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Abstract
backgroundDecreases in length of stay (LOS) in hospital after breast cancer surgery can be partly attributed to the change to less radical surgery, but many other factors are operating at the patient, surgeon and hospital levels. This study aimed to describe the changes in and predictors of length of stay (LOS) in hospital after surgery for breast cancer between 1997/98 and 2004/05 in two regions of England.
methodsCases of female invasive breast cancer diagnosed in two English cancer registry regions were linked to Hospital Episode Statistics data for the period 1st April 1997 to 31st March 2005. A subset of records where women underwent mastectomy or breast conserving surgery (BCS) was extracted (n = 44,877). Variations in LOS over the study period were investigated. A multilevel model with patients clustered within surgical teams and NHS Trusts was used to examine associations between LOS and a range of factors.
resultsOver the study period the proportion of women having a mastectomy reduced from 58% to 52%. The proportion varied from 14% to 80% according to NHS Trust. LOS decreased by 21% from 1997/98 to 2004/05 (LOSratio = 0.79, 95%CI 0.77-0.80). BCS was associated with 33% shorter hospital stays compared to mastectomy (LOSratio = 0.67, 95%CI 0.66-0.68). Older age, advanced disease, presence of comorbidities, lymph node excision and reconstructive surgery were associated with increased LOS. Significant variation remained amongst Trusts and surgical teams.
conclusionThe number of days spent in hospital after breast cancer surgery has continued to decline for several decades. The change from mastectomy to BCS accounts for only 9% of the overall decrease in LOS. Other explanations include the adoption of new techniques and practices, such as sentinel lymph node biopsy and early discharge. This study has identified wide variation in practice with substantial cost implications for the NHS. Further work is required to explain this variation.
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