The Experts below are selected from a list of 61590 Experts worldwide ranked by ideXlab platform

S. Paterson-brown - One of the best experts on this subject based on the ideXlab platform.

Ajay Aggarwal - One of the best experts on this subject based on the ideXlab platform.

  • impact of cancer service Centralisation on the radical treatment of men with high risk and locally advanced prostate cancer a national cross sectional analysis in england
    International Journal of Cancer, 2019
    Co-Authors: M Parry, Arunan Sujenthiran, Thomas E Cowling, Julie Nossiter, Paul Cathcart, Noel W Clarke, Heather Payne, Ajay Aggarwal
    Abstract:

    In many countries, specialist cancer services are centralised to improve outcomes. We explored how Centralisation affects the radical treatment of high-risk and locally advanced prostate cancer in the English NHS. 79,085 patients diagnosed with high-risk and locally advanced prostate cancer in England (April 2014 to March 2016) were identified in the National Prostate Cancer Audit database. Poisson models were used to estimate risk ratios (RR) for undergoing radical treatment by whether men were diagnosed at a regional co-ordinating centre ('hub'), for having surgery by the presence of surgical services on-site, and for receiving high dose-rate brachytherapy (HDR-BT) in addition to external beam radiotherapy by its regional availability. Men were equally likely to receive radical treatment, irrespective of whether they were diagnosed in a hub (RR 0.99, 95% CI 0.91-1.08). Men were more likely to have surgery if they were diagnosed at a hospital with surgical services on site (RR 1.24, 1.10-1.40), and more likely to receive additional HDR-BT if they were diagnosed at a hospital with direct regional access to this service (RR 6.16, 2.94-12.92). Centralisation of specialist cancer services does not affect whether men receive radical treatment, but it does affect treatment modality. Centralisation may have a negative impact on access to specific treatment modalities.

R.j.e. Skipworth - One of the best experts on this subject based on the ideXlab platform.

Andy R Ness - One of the best experts on this subject based on the ideXlab platform.

  • clinical directors views of Centralisation and commissioning of cleft services in the uk
    BMC Oral Health, 2015
    Co-Authors: Aidan Searle, Andy R Ness, Julia K Scott, Jonathan R Sandy, Andrea Waylen
    Abstract:

    Background To determine the views of Clinical Directors working in the United Kingdom (U.K.) Cleft Service with regard to Centralisation, commissioning and impact on cleft service provision.

  • The costs of Centralisation: a systematic review of the economic impact of the Centralisation of cancer services
    European journal of cancer care, 2012
    Co-Authors: William Hollingworth, Andy R Ness
    Abstract:

    KE K.M., HOLLINGWORTH W. & NESS A.R. (2012) European Journal of Cancer Care21, 158–168 The costs of Centralisation: a systematic review of the economic impact of the Centralisation of cancer services While evidence suggests that within specific cancer sites Centralisation of services improves outcomes and quality of care, the economic impact of Centralisation is unclear. This systematic review identified 19 studies that have investigated whether or not the Centralisation of cancer services results in economies of scale, or is cost-effective, or increases the costs of accessing care for patients and their carers. Evidence from 13 studies suggests that increasing surgeon volumes are associated with cost reductions, although one study suggested that this relationship is U-shaped and the evidence is not consistent for hospital volumes and costs. Only one study demonstrated that Centralisation was cost-effective with an incremental cost utility ratio of $5029 (€3616) per quality-adjusted life year gained. Consistent evidence from four studies suggested that centralised services increase the costs of accessing care for patients and their carers. Current evidence on the economic impact of Centralisation of cancer services is limited and of poor quality. Therefore, it remains unclear whether Centralisation results in economies of scale and is cost-effective. Future research should be based on a clear definition of the different components of Centralisation in order to determine which aspects of Centralisation are efficient and for which cancer subgroups.

M Parry - One of the best experts on this subject based on the ideXlab platform.

  • impact of cancer service Centralisation on the radical treatment of men with high risk and locally advanced prostate cancer a national cross sectional analysis in england
    International Journal of Cancer, 2019
    Co-Authors: M Parry, Arunan Sujenthiran, Thomas E Cowling, Julie Nossiter, Paul Cathcart, Noel W Clarke, Heather Payne, Ajay Aggarwal
    Abstract:

    In many countries, specialist cancer services are centralised to improve outcomes. We explored how Centralisation affects the radical treatment of high-risk and locally advanced prostate cancer in the English NHS. 79,085 patients diagnosed with high-risk and locally advanced prostate cancer in England (April 2014 to March 2016) were identified in the National Prostate Cancer Audit database. Poisson models were used to estimate risk ratios (RR) for undergoing radical treatment by whether men were diagnosed at a regional co-ordinating centre ('hub'), for having surgery by the presence of surgical services on-site, and for receiving high dose-rate brachytherapy (HDR-BT) in addition to external beam radiotherapy by its regional availability. Men were equally likely to receive radical treatment, irrespective of whether they were diagnosed in a hub (RR 0.99, 95% CI 0.91-1.08). Men were more likely to have surgery if they were diagnosed at a hospital with surgical services on site (RR 1.24, 1.10-1.40), and more likely to receive additional HDR-BT if they were diagnosed at a hospital with direct regional access to this service (RR 6.16, 2.94-12.92). Centralisation of specialist cancer services does not affect whether men receive radical treatment, but it does affect treatment modality. Centralisation may have a negative impact on access to specific treatment modalities.