Evidence map›Paper›PMID 24787104›Full record

ArticleSurgery2014

For-profit hospital ownership status and use of brachytherapy after breast-conserving surgery.

Sounok Sen, Pamela R Soulos, Jeph Herrin, Kenneth B Roberts, James B Yu, Beth-Ann Lesnikoski, Joseph S Ross, Harlan M Krumholz, Cary P Gross

Abstract readComparative Study
In one paragraph

Article in Surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Disparities in Colorectal Cancer Treatment Delay Within Appalachia--The Role of For-Profit Hospitals.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2015
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Sounok SenCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT.
Pamela R SoulosCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT; Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT.
Jeph HerrinCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT; Health Research & Educational Trust, Chicago, IL; Department of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT.
Kenneth B RobertsCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT; Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT.
James B YuCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT; Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT.
Beth-Ann LesnikoskiJFK Medical Center, Atlantis, FL.
Joseph S RossJFK Medical Center, Atlantis, FL; Robert Wood Johnson Clinical Scholars Program, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT.
Harlan M KrumholzDepartment of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT; Robert Wood Johnson Clinical Scholars Program, New Haven, CT; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT; Section of Health Policy and Administration, Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT.
Cary P GrossCancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale Cancer Center and Yale University School of Medicine, New Haven, CT; Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT. Electronic address: cary.gross@yale.edu.

Funding

Yale University Clinical and Translational Science Award ProgramUL1TR000142 · NCATS · YALE UNIVERSITY · PI SHERWIN, ROBERT S · 2012 to 2015
$31.8M
Center for Cardiovascular Outcomes Research at Yale UniversityU01HL105270 · NHLBI · YALE UNIVERSITY · PI CURTIS, JEPTHA PELHAM, KRUMHOLZ, HARLAN MARC · 2010 to 2013
$5.8M
Use and Outcomes of Radiation Therapy for Medicare Patients with Common CancersR01CA149045 · NCI · YALE UNIVERSITY · PI GROSS, CARY P. · 2010 to 2012
$1.5M
Impact of Publicity Reporting Hospital Outcome Measures for Older AdultsK08AG032886 · NIA · YALE UNIVERSITY · PI ROSS, JOSEPH SOLOMON · 2008 to 2012
$738k
NCATS NIH HHS UL1 TR000142NCI NIH HHS R01 CA149045NCI NIH HHS R01CA149045NHLBI NIH HHS U01 HL105270NHLBI NIH HHS U01 HL105270-03NIA NIH HHS K08 AG032886
6 · The paper itself

Abstract

backgroundLittle is known about the relationship between operative care for breast cancer at for-profit hospitals and subsequent use of adjuvant radiation therapy (RT). Among Medicare beneficiaries, we examined whether hospital ownership status is associated with the use of breast brachytherapy--a newer and more expensive modality--as well as overall RT.

methodsWe conducted a retrospective study of female Medicare beneficiaries who received breast-conserving surgery for invasive breast cancer in 2008 and 2009. We assessed the relationship between hospital ownership and receipt of brachytherapy or overall RT by using hierarchical generalized linear models.

resultsThe sample consisted of 35,118 women, 8.0% of whom had breast-conserving operations at for-profit hospitals. Among patients who received RT, those who underwent operation at for-profit hospitals were more likely to receive brachytherapy (20.2%) than patients treated at not-for-profit hospitals (15.2%; odds ratio [OR] for for-profit versus not-for-profit: 1.50; 95% confidence interval [95% CI] 1.23-1.84; P < .001). Among women aged 66-79 years, there was no relationship between hospital ownership status and overall use of RT. Among women ages 80-94 years of age--the group least likely to benefit from RT due to shorter life expectancy--undergoing breast-conserving operations at a for-profit hospital was associated with greater overall use of RT (OR 1.22; 95% CI 1.03-1.45, P = .03) and brachytherapy use (OR 1.66; 95% CI 1.18-2.34, P = .003).

conclusionOperative care at for-profit hospitals was associated with increased use of the newer and more expensive RT modality, brachytherapy. Among the oldest women who are least likely to benefit from RT, operative care at a for-profit hospital was associated with greater overall use of RT, with this difference largely driven by the use of brachytherapy.

Indexed as

Mastectomy, SegmentalAgedAged, 80 and overBrachytherapyBreast NeoplasmsCombined Modality TherapyFemaleHealth Care CostsHospital CostsHospitals, ProprietaryHospitals, VoluntaryHumansLinear ModelsMedicareOwnershipRetrospective Studies

Identifiers

PMID24787104
PMCPMC4008843

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.