医学
结直肠癌
比例危险模型
逻辑回归
内科学
癌症
队列
阶段(地层学)
多学科团队
倾向得分匹配
队列研究
急诊医学
护理部
生物
古生物学
作者
Yueh-Han Hsu,Pei-Tseng Kung,Shih-Ting Wang,Chuan-Yin Fang,Wen-Chen Tsai
出处
期刊:Health policy
[Elsevier]
日期:2016-06-01
卷期号:120 (6): 674-681
被引量:18
标识
DOI:10.1016/j.healthpol.2016.04.001
摘要
The evidence of improved survival in patients of colorectal cancer (CRC) receiving multidisciplinary team (MDT) care remains inconclusive.All patients with incident CRC but no prior cancer history in 2005-2008 were included and followed till 2010. A logistic regression model was used to predict the associated factors to participate in the MDT care model. The propensity score method was included under Cox proportional hazards model to reduce potential bias and to conduct survival analyses.In total, 25,766 patients were included; the mean follow-up period was 35.1 months. The factors associated with participating in MDT included receiving treatments at regional hospitals, at private hospitals, and stage III cancer (all p values <0.001). The favorable survival factors included participating in MDT (HR=0.91, p=0.001), age of 45-75, top-ranked income group, receiving treatments at district hospitals, or at hospitals or with doctors that had higher service volumes (all p values <0.05). Regarding individual stages, the risk of mortality was significantly lower at stage IV (HR=0.88, p=0.002).Colorectal cancer patients with participation in MDT have a lower mortality risk; the improvements of survival exist in all colorectal cancer patients, especially in those with stage IV disease.
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