Factors influencing the selection of a hospital for colon cancer surgery in Japan: analysis of the effects of surgery volume, hospital functions, and geographic conditions.

OBJECTIVE

To identify factors influencing the hospital choice of patients who undergo colon cancer surgery.

METHODS

We conducted a multivariate analysis using micro data from the Patient Survey and the Survey of Medical Institutions conducted by the Statistics and Information Department, Minister's Secretariat, Ministry of Health, Labour and Welfare of Japan, to identify patient and hospital characteristics which influence a patient's decision whether to undergo surgery at a hospital where many colon surgeries have been performed ("high-volume hospital").

RESULTS

Hospitalizations to high-volume hospitals were linked to factors such as referral from nonmedical facilities and the fact that the medical institution was a teaching hospital. Hospitalizations to high-volume hospitals decreased by about 8% for every 1-km increase in distance to the nearest high-volume hospital.

CONCLUSION

Geographic factors and hospital function had an impact on admission to high-volume hospitals that are expected to contribute to functionalization of medical institutions and improvement of medical standards. This suggests that geographic conditions should be considered in planning regional coordination systems for specialized medical care.