Authors' results and conclusions: The results have been grouped together in three blocks, one for each type of cancer and, in every of them, it has been pointed out the number of references that prove the direct relation between volume and best clinical results, as well as those that do not provide any evidence in favour of this relation. In surgeries performed for colorectal cancer, eight of the eleven studies included confirm the relation as opposed to three that do not; and the meta-analysis reports that mortality at 30 days decreases at hospitals where there is a great number of patients in comparison with hospitals with a lower number of patients (OR: 1.112; CI 95% 0.986-1.255). It happens the same thing with long-term survival (OR: 1.114; CI 95% 1.105-1.183). The bibliographical search on the costs of colorectal cancer interventions and the relation with volume showed that the interventions in those hospitals with great volume involved a lower cost per intervention and lower mean of hospital stay. However, there was scarce evidence (two papers) backing this. On another state of affairs, the comparative analysisof the costs associated with moves from centres located at basic areas to a hypothetical functional unit showed that the step over performing an intervention in high volume centres as opposed to those of low volume can even compensate for the costs that moves from the most expensive scenario convey.In lung cancer, six out of ten studies included in the review confirm the intervention as opposed to four studies not backing it. Finally, for breast cancer, five out of the eight papers included backs the relation as opposed to two which do not and one that supports it only when comparing hospitals of lower volume with those with higher volume.

Authors' recommendations: To conclude with, there can be affirmed that postoperatory mortality at short- and long-term is lower in hospitals with greater volume of cases per year in the three types of neoplasia, which have been included in the present report. Under the initial premise stating that new specialties units approach to hospitals with bigger volume of interventions per year, there could be said that new organizational models, in which specialization and coordination of the set of caring activities related to integral care delivered to cancer patients are trying to be improved, the new organizational models of specialization units of cancer patient caring get better results.

Project Status: Completed

URL for project: https://www.aetsa.org/publicacion/modelos-organizativos-en-la-asistencia-a-pacientes-con-cancer/

Year Published: 2009

URL for published report: https://www.aetsa.org/download/publicaciones/antiguas/AETSA_2006-33_Org_Oncologicos.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Andalusian Health Technology Assessment Area

Contact Address: Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309

Contact Name: aetsa.csalud@juntadeandalucia.es

Contact Email: aetsa.csalud@juntadeandalucia.es

Copyright: Andalusian Agency for Health Technology Assessment (AETSA)