Does A Medical Consortium Influence Health Outcomes of Hospitalized Cancer Patients? An Integrated Care Model in Shanxi, China

Miao Cai; Echu Liu; Hongbing Tao; Zhengmin Qian; Qiang (John) Fu; Xiaojun Lin; Manli Wang; Chang Xu; Ziling Ni

doi:10.5334/ijic.3588

Figures & Tables

Table 1

Descriptive statistics of patient characteristics before and after propensity score matching in different groups.

	Means – Lung cancer				Means – Stomach cancer				Means – Esophageal cancer
	Treated n = 1,598	unmatched Control n = 6,595	matched Control n = 1,598	percentage of improvement	Treated n = 1,008	unmatched Control n = 4,685	matched Control n = 1,008	percentage of improvement	Treated n = 451	unmatched Control n = 2,351	matched Control n = 451	percentage of improvement
Gender:
Female	0.292	0.271	0.299	68.1	0.173	0.202	0.202	–0.8	0.457	0.351	0.486	72.9
Male	0.708	0.729	0.701	68.1	0.827	0.798	0.798	–0.8	0.543	0.650	0.514	72.9
Age group:
18–44	0.021	0.026	0.027	17.0	0.050	0.035	0.046	72.5	0.007	0.008	0.004	130.0
45–54	0.187	0.100	0.109	10.4	0.125	0.106	0.115	48.1	0.106	0.074	0.084	31.6
55–64	0.290	0.275	0.304	9.9	0.286	0.273	0.267	–48.2	0.328	0.288	0.277	–28.2
65–74	0.348	0.331	0.338	41.4	0.369	0.361	0.387	–114.6	0.344	0.349	0.368	–340.9
75–84	0.135	0.230	0.188	43.5	0.152	0.202	0.157	90.1	0.195	0.244	0.237	14.1
>85	0.019	0.039	0.034	23.3	0.019	0.024	0.029	–114.3	0.020	0.037	0.029	46.7
Status upon admission:
Normal	0.987	0.827	0.977	93.4	0.986	0.834	0.980	96.1	0.998	0.879	0.993	96.2
Acute	0.001	0.038	0.004	91.4	0.001	0.032	0.001	100.0	0.000	0.021	0.000	100.0
urgent	0.011	0.033	0.019	66.0	0.013	0.029	0.019	62.1	0.002	0.018	0.007	72.4
other	0.000	0.102	0.000	100.0	0.000	0.105	0.000	100.0	0.000	0.082	0.000	100.0
surgery conducted or not	0.033	0.448	0.031	99.5	0.142	0.494	0.204	82.2	0.087	0.522	0.129	90.3
C3 index	0.388	0.620	0.475	62.3	0.315	0.473	0.405	43.2	0.283	0.463	0.421	23.3
No. of open beds	427.4	474.0	338.6	–91.0	407.9	429.6	357.5	–131.7	413.4	457.7	354.8	–32.1
No. of regular budget physicians	137.9	151.1	117.8	–52.1	122.4	134.5	109.1	–9.5	132.5	137.2	113.4	–307.7
No. of extra contracted physicians	137.7	153.2	113.5	–55.6	124.4	132.4	107.1	–116.6	123.9	133.2	105.7	–96.0
No. of regular budget nurses	38.3	58.8	26.1	40.7	35.7	51.9	29.8	62.8	36.3	55.6	27.4	54.2
No. of extra contracted nurses	154.2	141.2	110.5	–234.4	146.1	128.0	127.6	–2.2	150.9	135.3	120.0	–97.8

Product-Limit Survival Estimates of Matched Full Sample Patients.

Product-Limit Survival Estimates of 3 Matched Cancer Patients Lung Cancer Patients.
*Note*: Strata = 0 denotes patients enrolled in non-Medical Consortium Hospitals, strata = 1 denotes patients enrolled in Medical Consortium Hospitals.

Table 2

Maximum likelihood estimates of multivariable Cox hazard model.

Parameter	Lung cancer				Stomach cancer				Esophageal cancer
Parameter	Hazard Ratio	Pr > ChiSq	95% Hazard Ratio Confidence Limits		Hazard Ratio	Pr > ChiSq	95% Hazard Ratio Confidence Limits		Hazard Ratio	Pr > ChiSq	95% Hazard Ratio Confidence Limits
Non-medical consortium hospitals	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Medical consortium hospitals	0.533	<.001	0.439	0.648	0.494	<.001	0.386	0.634	0.505	<.001	0.361	0.708
Age groups:
18–44	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
45–54	1.122	0.693	0.633	1.990	0.847	0.595	0.460	1.560	0.244	0.065	0.055	1.089
55–64	1.075	0.792	0.627	1.843	0.697	0.210	0.396	1.226	0.168	0.017	0.039	0.727
65–74	1.132	0.650	0.662	1.934	0.801	0.427	0.463	1.385	0.214	0.039	0.049	0.924
75–84	1.329	0.311	0.767	2.304	0.680	0.202	0.376	1.229	0.257	0.071	0.059	1.125
>85	1.224	0.542	0.640	2.341	0.913	0.815	0.424	1.964	0.513	0.428	0.098	2.673
Gender
Female	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.
Male	0.895	0.247	0.742	1.080	0.907	0.493	0.685	1.200	1.134	0.439	0.825	1.557
Status upon admission
Ordinary	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	Ref.	–	–	–	–
Acute	5.657	<.001	2.492	12.841	7.902	0.041	1.086	57.506	–	–	–	–
Urgent	2.696	<.0001	1.750	4.155	2.447	0.010	1.236	4.843	–	–	–	–
Surgery conducted or not	0.543	0.023	0.320	0.921	0.596	0.006	0.411	0.864	1.307	0.334	0.760	2.248
C3 Index	0.994	0.935	0.856	1.153	0.981	0.875	0.769	1.251	0.970	0.818	0.750	1.255
No. of open beds	0.998	<.001	0.997	0.999	0.998	0.002	0.996	0.999	0.999	0.209	0.997	1.001
No. of regular budget physicians	1.006	<.001	1.003	1.008	1.009	0.000	1.004	1.014	1.004	0.196	0.998	1.009
No. of extra contracted physicians	1.013	<.001	1.008	1.018	1.009	0.065	0.999	1.018	0.998	0.765	0.986	1.010
No. of regular budget nurses	0.995	<.001	0.993	0.998	0.989	<.001	0.984	0.993	0.997	0.242	0.991	1.002
No. of extra contracted nurses	0.993	<.001	0.991	0.995	0.999	0.531	0.995	1.002	0.997	0.192	0.993	1.001
Interaction	1.010	0.002	1.004	1.016	1.019	0.014	1.004	1.035	–	–	–	–

[i] Ref. denotes the reference group;

The interaction term is the product of the variable that does not meet the proportional hazard assumption and the survival time variable.

Does A Medical Consortium Influence Health Outcomes of Hospitalized Cancer Patients? An Integrated Care Model in Shanxi, China

Figures & Tables

Table 1

Figure 1

Figure 2

Table 2

Paradigm

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