Cancer patients who need certain surgeries have better outcomes when the procedure is done at a hospital that sees a high volume of similar cases, according to a new study.
Hospitals that only do a few surgeries a year for certain types of cancer have higher mortality rates for those procedures, according to a California HealthCare Foundation November report.
Many California hospitals perform one or two surgeries each year for a number of cancers, despite the fact that their patients often live within 50 miles of another, higher-volume hospital that has better outcomes.
Many patients statewide “are having their cancer surgeries in hospitals that do small numbers of these surgeries in a year, despite the extensive research demonstrating the link between low volume and poor patient outcomes,” the report states.
Last year, 674 cancer surgeries occurred in California hospitals that do one or two surgeries for that type of cancer that year, a very low volume. Almost 75 percent of California hospitals — or 249 out of 341 — participated in a low volume cancer surgery.
Those patients might have been better off looking for a hospital that performed surgery on their particular type of cancer routinely, the authors write.
People with less common cancers, such as those of the bladder, esophagus, pancreas and stomach, are more likely than those with more common cancers to have surgery in a low-volume hospital.
For example, in 2014, 897 people had surgery for bladder cancer in California. But 9 percent of them, or about 81 people, had surgery at a hospital that only did one or two of those surgeries that year. Of the 124 hospitals that performed bladder cancer surgeries that year, 83 of them did a very small volume of the procedures.
Nearly three-quarters of California cancer patients who had surgery at a very low-volume hospital in 2014 lived within reasonable driving distance of a hospital with a better record for that type of surgery, “where they may have been less likely to risk poor outcomes,” the report states.
The researchers call into question whether hospitals should be performing low-volume surgeries if another high-volume hospital is nearby, and encourage health providers to help their patients to make an informed choice.
“When patients, in partnership with their providers, decide that surgery will be part of the treatment plan, patients should be made aware of and should use the data to make decisions about location of their care, and should be provided with resources for travel to those preferred locations, when necessary,” the report states.