PMID- 37548150 OWN - NLM STAT- MEDLINE DCOM- 20231023 LR - 20231023 IS - 1651-226X (Electronic) IS - 0284-186X (Linking) VI - 62 IP - 8 DP - 2023 Aug TI - The impact of a multi-hospital network on the inequality in odds of receiving resection or ablation for synchronous colorectal liver metastases. PG - 842-852 LID - 10.1080/0284186X.2023.2238545 [doi] AB - BACKGROUND: This study investigates whether inequalities in the utilization of resection and/or ablation for synchronous colorectal liver metastases (SCLM) between patients diagnosed in expert and non-expert hospitals changed since a multi-hospital network started. MATERIALS AND METHODS: Patients diagnosed with SCLM between 2009 and 2020 were included. The likelihood of receiving ablation and/or resection was analyzed in the prenetwork (2009-2012), startup (2013-2016), and matured-network (2017-2020) periods. RESULTS: Nationwide, 13.981patients were diagnosed between 2009 and 2020, of whom 1.624 were diagnosed in the network. Of patients diagnosed in the network's expert hospitals, 36.7% received ablation and/or resection versus 28.3% in nonexpert hospitals (p < 0.01). The odds ratio (OR) of receiving ablation and/or resection for patients diagnosed in expert versus nonexpert hospitals increased from 1.38 (p = 0.581, pre-network), to 1.66 (p = 0.108, startup), to 2.48 (p = 0.090, matured-network). Nationwide, the same trend occurred (respectively OR 1.41, p = 0.011; OR 2.23, p < 0.001; OR 3.20, p < 0.001). CONCLUSIONS: Patients diagnosed in expert hospitals were more likely to receive ablation and/or resection for SCLM than patients diagnosed in non-expert hospitals. This difference increased over time despite the startup of a multi-hospital network. Establishing a multi-hospital network did not have an effect on reducing the existing unequal odds of receiving specialized treatment. SYNOPSIS: Specialized oncology treatments are increasingly provided through multi-hospital networks. However, scant empirical evidence on the effectiveness of these networks exists. This study analyzes whether a regional multi-hospital network was able to improve equal access to specialized oncology treatments. FAU - van der Ven, Roos G F M AU - van der Ven RGFM AUID- ORCID: 0000-0003-4605-8497 AD - Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands. AD - Department of Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands. AD - Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. FAU - Westra, Daan AU - Westra D AUID- ORCID: 0000-0003-1791-3626 AD - Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands. FAU - van Erning, Felice N AU - van Erning FN AUID- ORCID: 0000-0003-0125-1429 AD - Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. AD - Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands. FAU - de Hingh, Ignace H AU - de Hingh IH AUID- ORCID: 0000-0003-3491-4268 AD - Department of Oncology and Developmental Biology (GROW), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands. AD - Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. AD - Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands. FAU - Olde Damink, Steven W M AU - Olde Damink SWM AUID- ORCID: 0000-0002-5202-9345 AD - Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. AD - Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany. FAU - Paulus, Agnes AU - Paulus A AUID- ORCID: 0000-0002-2086-6106 AD - Department of Health Services Research, Faculty of Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, Maastricht, The Netherlands. AD - Faculty of Health, Medicine and Life Sciences (FHML), School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands. FAU - Leclercq, Wouter K G AU - Leclercq WKG AUID- ORCID: 0000-0003-1159-1857 AD - Department of Surgery, Maxima Medical Center, Eindhoven and Veldhoven, The Netherlands. FAU - den Dulk, Marcel AU - den Dulk M AUID- ORCID: 0000-0002-6161-161X AD - Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands. AD - Department of General, Visceral and Transplantation Surgery, RWTH University Hospital Aachen, Aachen, Germany. CN - OncoZON Consortium LA - eng PT - Journal Article DEP - 20230807 PL - Sweden TA - Acta Oncol JT - Acta oncologica (Stockholm, Sweden) JID - 8709065 SB - IM MH - Humans MH - Hepatectomy MH - *Colorectal Neoplasms/pathology MH - *Liver Neoplasms/secondary MH - Hospitals MH - Probability MH - Treatment Outcome OTO - NOTNLM OT - Healthcare disparities OT - centralized hospital services OT - colorectal neoplasms OT - health services accessibility OT - multi-institutional systems OT - neoplasm metastasis EDAT- 2023/08/07 06:42 MHDA- 2023/10/23 12:44 CRDT- 2023/08/07 05:34 PHST- 2023/10/23 12:44 [medline] PHST- 2023/08/07 06:42 [pubmed] PHST- 2023/08/07 05:34 [entrez] AID - 10.1080/0284186X.2023.2238545 [doi] PST - ppublish SO - Acta Oncol. 2023 Aug;62(8):842-852. doi: 10.1080/0284186X.2023.2238545. Epub 2023 Aug 7.