Evidence map›Paper›PMID 31834527›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2020

Economic impacts of care by high-volume providers for non-curative esophagogastric cancer: a population-based analysis.

Julie Hallet, Nicole J Look Hong, Victoria Zuk, Laura E Davis, Vaibhav Gupta, Craig C Earle, Nicole Mittmann, Natalie G Coburn

Abstract read
PubMed Publisher
In one paragraph

Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Geographic impact on access to care and survival for non-curative esophagogastric cancer: a population-based study.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2021
    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

8 authors.

Julie HalletDivision of General Surgery, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075, Bayview Avenue, T2-063, Toronto, ON, M4N 3M5, Canada. Julie.hallet@sunnybrook.ca.
Nicole J Look HongDivision of General Surgery, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075, Bayview Avenue, T2-063, Toronto, ON, M4N 3M5, Canada.
Victoria ZukSunnybrook Research Institute, Toronto, ON, Canada.
Laura E DavisSunnybrook Research Institute, Toronto, ON, Canada.
Vaibhav GuptaDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Craig C EarleSunnybrook Research Institute, Toronto, ON, Canada.
Nicole MittmannSunnybrook Research Institute, Toronto, ON, Canada.
Natalie G CoburnDivision of General Surgery, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075, Bayview Avenue, T2-063, Toronto, ON, M4N 3M5, Canada.

Funding

Canadian Institute of Health Research 154131
6 · The paper itself

Abstract

backgroundEsophagogastric cancer (EGC) is one of the deadliest and costliest malignancies to treat. Care by high-volume providers can provide better outcomes for patients with EGC. Cost implications of volume-based cancer care are unclear. We examined the cost-effectiveness of care by high-volume medical oncology providers for non-curative management of EGC.

methodsWe conducted a population-based cohort study of non-curative EGC over 2005-2017 by linking administrative datasets. High-volume was defined as ≥ 11 patients/provider/year. Healthcare costs ($USD/patient/month-survived) were computed from diagnosis to death or end of follow-up from the perspective of the healthcare system. Multivariable quantile regression examined the association between care by high-volume providers and costs. Sensitivity analyses were conducted by varying costing horizons and high-volume definitions.

resultsAmong 7011 non-curative EGC patients, median overall survival was superior with care by high-volume providers with 7.0 (IQR 3.3-13.3) compared to 5.9 (IQR 2.6-12.1) months (p < 0.001) for low-volume providers. Median costs/patient/month-lived were lower for high-volume providers ($5518 vs. $5911; p < 0.001), owing to lower inpatient acute care costs, despite higher medication-associated and radiotherapy costs. Care by high-volume providers was independently associated with a reduction of $599 per patient/month-lived (95% confidence interval - 966 to - 331) compared to low-volume providers. The incremental cost-effectiveness ratio was - 393. Care by high-volume providers remained the dominant strategy when varying the costing horizon and the high-volume definition.

conclusionCare by high-volume providers for non-curative EGC is associated with superior survival and lower healthcare costs, indicating a dominant strategy that may provide an opportunity to improve cost-effectiveness of care delivery.

Indexed as

Cost-Benefit AnalysisAgedAged, 80 and overCanadaCombined Modality TherapyEsophageal NeoplasmsEsophagogastric JunctionFemaleFollow-Up StudiesHealth PersonnelHospitals, High-VolumeHumansMaleMiddle AgedPrognosisRetrospective StudiesCancerCostsEsophagealGastricOutcomesVolume

Identifiers

PMID31834527

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.