Hospital competition has improved short-term outcomes after prostate cancer surgery in the United Kingdom, according to a new study.
The national cohort study was to analyse data from all men who underwent prostate cancer surgery in the United Kingdom between 2008 and 2011 (n=12,925) to assess the effect of the centre being located in a competitive environment (based on the number of centres within a threshold distance) and being a successful competitor (based on the ability to attract patients from other hospitals) on postoperative hospital stay more than 3 days, 30-day emergency readmissions and 2-year urinary complications.
The findings, published in the journal Cancer, suggest that men who underwent surgery in centres located in a stronger competitive environment were less likely to have a 30-day emergency readmission, after adjustment for patient characteristics. The association was maintained irrespective of the type or volume of procedures performed at each centre (OR, 0.46; 95% CI, 0.36-0.60; P=.005).
Men who received treatment at centres that were successful competitors were less likely to have a length of hospital stay longer than 3 days (OR, 0.49; 95% CI, 0.25-0.94; P=.02).
The authors say the results suggest for the first time that hospital competition improves short-term outcomes after prostate cancer surgery.
“Further evaluation of the potential role of patient choice and hospital competition is required to inform health service design in contrast to the role of top-down-driven approaches, which have focused on centralisation of services,” they advise.
