Exploring the impact of regionalization activities on patients undergoing high-risk, resource-intensive cancer surgery in Canada
Sub-Study 2:Dataset Analysis
Primary objective is to evaluate in-hospital and post-discharge mortality rates pre- and post- regionalization implementation, adjusted for type of resection, patient characteristics, histological subtype and pre-admission co-morbidity.
Secondary outcomes will focus on evaluating the appropriateness of care via temporal and intra-group analyses:
- To evaluate pre-post regionalization impact on length of hospital stay, stratified by institutional and surgeon volume and adjusted for patient and tumour characteristics and comorbidities
- To evaluate pre-post regionalization resection rates, stratified by institutional and surgeon volume and adjusted for patient and tumour characteristics and comorbidities
- To investigate the estimated number of diagnostic tests billed to BC MSP per cancer event
- To compare resection rates between provincial databases
- To compare the rate, location and reason for Emergency Department presentation pre and post regionalization to detect if there has been any shift in the type or location of presentation
Sub-study 3: Geographical spatial analysis and GIS outcomes:
- To descriptively map the distribution of the high-risk cancer surgeries, stratified for institutional volume through the application of GIS hardware, software and techniques.
- To assess trends in surgical procedure clusters, analysis of service availability relative to population density, and accessibility of services as a function of travel times with urban and rural service catchments