RESUMO
OBJECTIVE: To determine the effectiveness and costs of different organizational models in caring for colorectal cancer patients through either clinical management functional units or traditional clinical services. METHOD: Post-operative and long-term (after 30 days and 5 years) mortality was analyzed according to number of patients undergoing surgery because of colorectal cancer. Mortality was adjusted for patient-related confounding factors. With that purpose a thorough review of the literature was conducted; information obtained was used in a meta-analysis of randomized effects. Concerning costs, a literature search was run to describe differences in number of patients per year between hospitals. RESULTS: Surgery costs were found to be smaller, and mean hospital stay shorter, in big-sized hospitals. The meta-analysis showed that the risk of death at 30 days and 5 years was lower in big hospitals versus smaller ones (OR: 1.112; 95% CI 0.986-1.255, and OR: 1.114; 95% CI 1.105-1.183, respectively). CONCLUSIONS: Short- and long-term postoperative mortality is lower in hospitals with a high number of cases per year.
Assuntos
Neoplasias Colorretais/economia , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/cirurgia , Custos e Análise de Custo , Tamanho das Instituições de Saúde , Humanos , Modelos Organizacionais , Análise de SobrevidaRESUMO
The first 7 cases of histologically and cytochemically confirmed Burkitt's lymphoma have recently been studied in Cuba. Some of them presented with facial bone involvement and high anti-Epstein-Barr virus (EBV) antibody titers characteristic of endemic African cases. Others showed features of nonendemic cases. The distribution of patients in these two groups may be in relation to the behavior of the healthy Cuban population with respect to the EBV virus.