Effect of surgeon specialty on processes of care and outcomes for ovarian cancer patients

Craig C. Earle, Deborah Schrag, Bridget A. Neville, K. Robin Yabroff, Marie Topor, Angela Fahey, Edward Trimble, Diane C. Bodurka, Robert E. Bristow, Michael Carney, Joan L. Warren

Research output: Contribution to journalArticle

Abstract

Background: For many diseases, specialized care (i.e., care rendered by a specialist) has been associated with superior-quality care (i.e., better outcomes). We examined associations between physician specialty and outcomes in a population-based cohort of elderly ovarian cancer surgery patients. Methods: We analyzed the Medicare claims, by physician specialty, of all women aged 65 years or older who underwent surgery for pathologically confirmed invasive epithelial ovarian cancer between January 1, 1992, and December 31, 1999, while living in an area monitored by the Surveillance, Epidemiology, and End Results (SEER) program to assess important care processes (i.e., the appropriate extent of surgery and use of adjuvant chemotherapy) and outcomes (i.e., surgical complications, ostomy rates, and survival). All statistical tests were two-sided. Results: Among 3067 ovarian cancer patients who underwent surgery, 1017 patients (33%) were treated by a gynecologic oncologist, 1377 patients (45%) by a general gynecologist, and 673 patients (22%) by a general surgeon. Among patients with stage I or II disease, those treated by a gynecologic oncologist (60%) were more likely to undergo lymph node dissection than those treated by a general gynecologist (36%) or a general surgeon (16%). Patients with stage III or IV disease were more likely to undergo a debulking procedure if the initial surgery was performed by a gynecologic oncologist (58%) than by a general gynecologist (51%) or a general surgeon (40%; P

Original languageEnglish (US)
Pages (from-to)172-180
Number of pages9
JournalJournal of the National Cancer Institute
Volume98
Issue number3
DOIs
StatePublished - Feb 1 2006
Externally publishedYes

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Ovarian Neoplasms
Ostomy
SEER Program
Physicians
Quality of Health Care
Adjuvant Chemotherapy
Medicare
Surgeons
Lymph Node Excision
Survival Rate
Population
Oncologists

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Earle, C. C., Schrag, D., Neville, B. A., Yabroff, K. R., Topor, M., Fahey, A., ... Warren, J. L. (2006). Effect of surgeon specialty on processes of care and outcomes for ovarian cancer patients. Journal of the National Cancer Institute, 98(3), 172-180. https://doi.org/10.1093/jnci/djj019

Effect of surgeon specialty on processes of care and outcomes for ovarian cancer patients. / Earle, Craig C.; Schrag, Deborah; Neville, Bridget A.; Yabroff, K. Robin; Topor, Marie; Fahey, Angela; Trimble, Edward; Bodurka, Diane C.; Bristow, Robert E.; Carney, Michael; Warren, Joan L.

In: Journal of the National Cancer Institute, Vol. 98, No. 3, 01.02.2006, p. 172-180.

Research output: Contribution to journalArticle

Earle, CC, Schrag, D, Neville, BA, Yabroff, KR, Topor, M, Fahey, A, Trimble, E, Bodurka, DC, Bristow, RE, Carney, M & Warren, JL 2006, 'Effect of surgeon specialty on processes of care and outcomes for ovarian cancer patients', Journal of the National Cancer Institute, vol. 98, no. 3, pp. 172-180. https://doi.org/10.1093/jnci/djj019
Earle, Craig C. ; Schrag, Deborah ; Neville, Bridget A. ; Yabroff, K. Robin ; Topor, Marie ; Fahey, Angela ; Trimble, Edward ; Bodurka, Diane C. ; Bristow, Robert E. ; Carney, Michael ; Warren, Joan L. / Effect of surgeon specialty on processes of care and outcomes for ovarian cancer patients. In: Journal of the National Cancer Institute. 2006 ; Vol. 98, No. 3. pp. 172-180.
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AU - Fahey, Angela

AU - Trimble, Edward

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