Impact of patient choice and hospital competition on patient outcomes after prostate cancer surgery: A national population‐based study

摘要: BACKGROUND: Policies that encourage patient choice and hospital competition have been introduced across several countries with the purpose of improving quality health care services. The objective current national cohort study was to analyze correlation between on outcomes after cancer surgery using prostate as a case study. METHODS: analyses included all men who underwent in United Kingdom 2008 2011 (n = 12,925). Multilevel logistic regression used assess effect radical prostatectomy center being located competitive environment (based number centers within threshold distance) successful competitor ability attract patients from other hospitals) 3 patient-level outcomes: postoperative length stay >3 days, 30-day emergency readmissions, 2-year urinary complications. RESULTS: With adjustment for characteristics, stronger were less likely readmission, irrespective type or volume procedures performed at each (odds ratio, 0.46; 95% confidence interval, 0.36-0.60; P .005). Men received treatment competitors days 0.49; 0.25-0.94; .02). CONCLUSIONS: results suggest first time improves short-term surgery. Further evaluation potential role is required inform service design contrast top-down-driven approaches, which focused centralization