Variation in work-up and treatment procedures among types of radiation therapy facilities: The patterns of care process survey for three head and neck sites

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Abstract
The PCS Process Survey analyzed radiation therapy facilities to evaluate procedures in work-up and treatment of patients with cancer of the larynx, tongue, and nasopharynx. Types of facilities are compared to establish bench marks in performance of work-up and treatment procedures that can be used as a foundation for upgrading care and for adjusting studies to follow this paper. A statistical method is demonstrated that provides a “signature” of relative performance over a standardized set of procedural criteria. Facilities with resident training programs perform nearly all of these procedures much more consistently than do nontraining facilities. Facilities with full-time head therapists perform most procedures more consistently than do facilities with part-time heads. A third comparison of large versus small facilities shows that among training facilities size has no effect and that among full-time facilities size has a slight effect. Among part-time facilities, however, smaller ones fail to perform most procedures more often than larger facilities. The size difference is confounded with the full-time/part-time difference because part-time facilities are on the average smaller than facilities with full-time head therapists.