Cross-sectional analysis reveals substantial variations in radiation therapy utilization and costs across hospitals, suggesting regional centralization could improve clinical outcomes.
There are large variations in input, output and cost of radiation therapy among different categories of hospitals. Hospitals with similar patient loads exhibit similar investment, staffing patterns and disease mix. The use of facilities, equipment and staff in low-patient-load hospitals is less intensive and includes a high proportion of benign conditions. The high-patient-load centers make more intensive use of their resources and treat a far higher proportion of patients with cancer, and the therapy provided is more expensive. The greater cost is due mainly to the larger and more diversified staff administering radiation therapy. Five major centers could provide the necessary radiation therapy in the area studied. The cost would probably be higher, but the results could well be superior.
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Bloom et al. (1972) studied this question.