Influence of Patient and Hospital Characteristics on the Performance of Direct Reconstruction after Mastectomy.

摘要: Aim: International studies have shown that the performance of a direct (or immediate) reconstruction (DR) after mastectomy is associated with patient (e.g., socio-economic status, insurance age) and hospital (number cases, teaching status) characteristics. The present article addresses question if such relationships also exist in Germany. Material Methods: results nationwide questionnaire to patients certified breast cancer centres were coupled clinical features characteristics hospital. Predictors for receiving DR (vs. delayed or no reconstruction) estimated by means logistic multilevel model sample 1165 from 105 locations. Results: Substantial differences between treating hospitals found (intraclass correlation coefficient null model: 0.195) which can part be explained total (total 0.169). Patients following are more likely receive DR: younger age, private health insurance, secondary school leaving certificate primary certificate), lower stage acquisition information about reconstruction. ASA partnership status not statistically significantly related DR. performed higher caseload cancer. Teaching operations per surgeon urbanity location Conclusions: Non-clinical case number DR, this poses questions concerning reasons equality care.