Navigation Links
Wait times up 78 percent at VA for colorectal cancer procedures
Date:8/26/2013

A study published in the August print issue of the Journal of Oncology Practice shows that from 1998-2008, wait times for colorectal cancer operations at Veterans Administration hospitals increased from 19 to 32 days. But researchers think longer waits may be a reflection of several unmeasured variables including more careful care, staffing, and patient conditions or preferences.

"Some of it is purely staffing we don't have enough surgeons or nurses or anesthetists or O.R. time to meet the need," says Martin McCarter, MD, investigator at the University of Colorado Cancer Center and surgical oncologist at the University of Colorado Hospital. "But some of this increase in wait times for cancer procedures at the VA may be due to an increased focus on quality and outcomes. Better care takes time."

The study used data from 17,487 patients listed in the VA Central Cancer Registry. McCarter and colleagues including first author Ryan Merkow, MD, former surgery resident at UCH, compared the time between diagnosis and definitive, cancer-directed therapy such as colectomy or rectal resection in 1998 and 2008. During this 10-year period, the median time from diagnosis to treatment increased from 19 to 32 days. At high-volume centers, increases were even more pronounced, jumping 14 days for the treatment of colon cancer and nearly 30 days for the treatment of rectal cancer.

"What's missing in this study are any cancer-related outcomes what's the effect of these longer wait times on survival or quality of life?" says McCarter. Reframed, the question is whether more careful care is worth the wait is it better to treat quickly in the days after diagnosis or to adopt the more modern, more careful approach that can push back treatment?

"For example, perhaps more VA doctors are taking into account a patient's comorbidities maybe someone has lung or heart problems in addition to cancer. And it can take a few days or even a few weeks to bring specialists for these other conditions onboard," McCarter says. McCarter points out that this question of the influence of time-to-treatment on outcomes is a larger question in the overall strategy of cancer care. "Although everybody assumes it's best to treat cancer as soon as possible, by the time they're detected, most tumors have been growing for years. It may be that a two-week delay before treatment makes no difference and that taking time to better plan care is a worthwhile trade," McCarter says.

The study also shows that patient, tumor and hospital factors influence time to treatment. Specifically, patients over age 55 were treated slightly more quickly than younger ones, and more advanced tumors were treated more quickly than less advanced ones both findings match the intuitive need to treat a more dangerous tumor efficiently. But then married (vs. unmarried) and white (vs. black) patients treated at low-volume (vs. high-volume) centers, and at the same hospital at which they were diagnosed also saw shorter wait times between diagnosis and treatment. Some of these factors may reflect other unmeasured influences such as a patient's desire for a second opinion before committing to surgery.

"VA's across the country realize that timeliness of care is an important issue. There's tremendous pressure to move people efficiently through the system. For example, wait times for an elective hernia repair may be up to 9 months because cancer patients take priority over elective or more benign situations and there just aren't enough resources to go around," McCarter says.

"The challenge for the future is to have our cake and eat it too to have quality along with the efficiency of shorter wait times," McCarter says.


'/>"/>

Contact: Garth Sundem
garth.sundem@ucdenver.edu
University of Colorado Denver
Source:Eurekalert

Related medicine news :

1. Fresh Healthy Vending Options Available at Historic Times Square hotel
2. Diet Doc Weight Loss Diets Reveal the Best Times to Eat Healthy Dinner Recipes to Make Losing Belly Fat Easier
3. Children exposed to lead 3 times more likely to be suspended from school
4. AAPT's Education-based Approach Discussed in New York Times
5. Nutrition in a Bottle: Sometimes More Hype Than Help, from the July 2013 Harvard Health Letter
6. Habits, not cravings, drive food choice during times of stress
7. Protecting the body in good times and bad
8. Second ACL injuries 6 times more likely after reconstruction
9. Digital Health Funding, Sensors, DNA, Big Data, and Reimbursement Hot Topics at Living in Digital Times' Digital Health Summer Summit
10. Declare Independence From Your Desk; Celebrate Productivity Like Colonial Times at StandUpDesks.com
11. Sometimes, the Most Evil Things Come from the Most Holy… 3 Gates of the Dead by Jonathan Ryan to be Published by Premier Digital Publishing on October 15, 2013
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... June 26, 2016 , ... On June 10-11, 2016, A ... 2016 Cereal Festival and World’s Longest Breakfast Table in Battle Creek, MI, where the ... history as home to some of the world’s leading providers of cereal and other ...
(Date:6/25/2016)... D.C. (PRWEB) , ... June 25, 2016 , ... ... discuss health policy issues and applications at AcademyHealth’s Annual Research Meeting June 26-28, ... their work on several important health care topics including advance care planning, healthcare ...
(Date:6/25/2016)... ... June 25, 2016 , ... As a lifelong Southern ... Laude and his M.D from the David Geffen School of Medicine at UCLA. He ... Los Angeles to complete his fellowship in hematology/oncology at the UCLA-Olive View-Cedars Sinai program ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic events may ... to unhealthy avenues, such as drug or alcohol abuse, as a coping mechanism. To ... for healthy coping following a traumatic event. , Trauma sufferers tend to feel a ...
(Date:6/24/2016)... ... June 24, 2016 , ... Dr. ... accelerated orthodontic treatment. Dr. Cheng has extensive experience with all areas of orthodontics, ... and accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to orthodontic ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... June 23, 2016 Research and Markets ... Medical Market Analysis 2016 - Forecast to 2022" report ... The report contains up to date financial data derived from ... of major trends with potential impact on the market during ... market segmentation which comprises of sub markets, regional and country ...
(Date:6/23/2016)... June 23, 2016 Bracket , a leading ... next generation clinical outcomes platform, Bracket eCOA (SM) 6.0, ... June 26 – 30, 2016 in Philadelphia ... Clinical Outcome Assessment product of its kind to fully integrate ... Bracket eCOA 6.0 is a flexible platform for electronic ...
(Date:6/23/2016)... -- Astellas today announced the establishment of Astellas Farma Colombia (AFC), a new affiliate with operations headquartered in ... . ... ... ... Astellas is ...
Breaking Medicine Technology: