ArticleChinese journal of cancer research = Chung-kuo yen cheng yen chiu2021
Associations of centralization with health care quality for gastric cancer patients receiving gastrectomy in China.
Article in Chinese journal of cancer research = Chung-kuo yen cheng yen chiu, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- The Impact of Hospital Volume on Postoperative Outcomes for Esophagectomy and Gastrectomy: A Systematic Review and Meta-analysis.Annals of surgical oncology · 2026Pooled it
- Effect of hospital volume on gastric cancer resection outcome in Switzerland: 24-year nationwide retrospective analysis.BJS open · 2025Article
- Heterogeneous effects of hospital competition on inpatient quality: an analysis of five common diseases in China.Health economics review · 2024Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveLimited evidence is available regarding the associations of centralization with gastric cancer patients' quality of care in high surgical volume settings. The current study aimed to explore the effects of hospital volume and the Herfindahl-Hirschman index (HHI) on in-hospital mortality, total cost, and length of stay for Chinese gastrectomy patients in a nationwide database.
methodsWe extracted data on gastrectomy for gastric cancer from the Hospital Quality Monitoring System Database between 2013 and 2018. Hospital volume was divided into 4 quartiles: low (1-83 cases per year), medium (84-238 cases), high (239-579 cases), and very high (580-1,193 cases). The HHI was divided into 3 categories: highly concentrated (>2,500), moderately concentrated (1,500-2,500), and unconcentrated (<1,500). We used mixed-effects models to analyze the data while accounting for data clustering.
resultsWe analyzed 125,683 patients in 515 institutions. In the multivariable analyses, hospital volume was significantly associated with in-hospital mortality [medium
conclusionsCentralization of gastrectomy, measured by hospital volume and the HHI, was associated with decreased in-hospital mortality and shortened length of stay without increasing total cost. These results support the strategy of centralizing gastrectomy in high-volume settings.
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