The Impact of Hospital Safety-Net Burden on Survival Outcomes in Oral Cavity Cancer Patients

Background Operating room slowdowns occur at specific intervals in the year as a cost-saving measure. We aim to investigate the impact of these slowdowns on the care of oral cavity cancer patients at a Canadian tertiary care centre.Methods A total of 585 oral cavity cancer patients seen between 1999 and 2015 at the London Health Science Centre (lhsc) Head and Neck Multidisciplinary Clinic were included in this study. Operating room hours and patient load from 2006 to 2014 were calculated. Our primary endpoint was the wait time from consultation to definitive surgery. Exposure variables were defined according to wait time intervals occurring during time periods with reduced operating room hours.Results Overall case volume rose significantly from 2006 to 2014 (p < 0.001), while operating room hours remained stable (p = 0.555). Patient wait times for surgery increased from 16.3 days prior to 2003 to 25.5 days in 2015 (p = 0.008). Significant variability in operating room hours was observed by month, with lowest reported for July and August (p = 0.002). The greater the exposure to these months, the more likely patients were to wait longer than 28 days for surgery (odds ratio per day [or]: 1.07, 95% confidence interval [ci]: 1.05 to 1.10, p < 0.001). Individuals seen in consultation preceding a month with below average operating room hours had a higher risk of disease recurrence and/or death (hazard ratio [hr]: 1.59, 95% ci: 1.10 to 2.30, p = 0.014).Conclusions Scheduled reductions in available operating room hours contribute to prolonged wait times and higher disease recurrence. Further work is needed to identify strategies maximizing efficient use of health care resources without negatively affecting patient outcomes.

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The Impact of Hospital Safety-Net Burden on Survival and Receipt of Chemoradiation in Anal Cancer Patients

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2019.06.2132 ◽

2019 ◽

Vol 105 (1) ◽

pp. E161

Author(s):

R. Balasubramaniyan ◽

M.M. Qureshi ◽

M.A. Dyer ◽

M.T. Truong ◽

K.S. Mak

Keyword(s):

Cancer Patients ◽

Anal Cancer ◽

Safety Net ◽

Hospital Safety ◽

The Impact

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The Role of Hospital Safety-Net Burden in the Treatment of Oral Cavity Cancers: Evaluating its Impact on Survival Outcomes

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2020.07.2454 ◽

2020 ◽

Vol 108 (3) ◽

pp. e404

Author(s):

C.M. Lam ◽

M.M. Qureshi ◽

J.J. Park ◽

M.T. Truong

Keyword(s):

Oral Cavity ◽

Safety Net ◽

Survival Outcomes ◽

Hospital Safety ◽

Impact On Survival ◽

Oral Cavity Cancers

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Less Is More? The Association between Survival and Follow-Up Protocol after Treatment in Oral Cavity Cancer Patients from a Betel Quid-Prevalent Region

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312596 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12596

Author(s):

Shih-An Liu ◽

Chen-Chi Wang ◽

Rong-San Jiang ◽

Yu-Chi Tung

Keyword(s):

Oral Cavity ◽

Cancer Patients ◽

Oral Cavity Cancer ◽

Demographic Data ◽

Final Analysis ◽

Treatment Modalities ◽

Imaging Studies ◽

Less Is More ◽

The Impact

The optimal follow-up protocol after treatment of oral cavity cancer patients is still debatable. We aimed to investigate the impact of frequency of different imaging studies and follow-up visits on the survival of oral cavity cancer patients. The current study retrospectively reviewed oral cavity cancer patients who underwent surgical intervention in our hospital. Basic demographic data, tumor-related features, treatment modalities, imaging studies, and clinic visits were recorded. Cox proportional hazard model was used to examine the influence of variables on the survival of oral cavity cancer patients. In total, 741 patients with newly diagnosed oral cavity cancer were included in the final analysis. Overall, the frequency of imaging studies was not associated with survival in the multivariate analysis, except PET scan (hazard ratio [HR]: 5.30, 95% confidence interval [CI]: 3.57–7.86). However, in late-stage and elder patients, frequent head and neck CT/MRI scan was associated with a better prognosis (HR: 0.55, 95% CI: 0.36–0.84; HR: 0.52, 95% CI: 0.30–0.91, respectively). In conclusion, precision medicine is a global trend nowadays. Different subgroups may need different follow-up protocols. Further prospective study is warranted to clarify the relationship between frequency of image studies and survival of oral cavity cancer patients.

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