The association between breast cancer patients’ general health perception and organizational characteristics of the hospital

Abstract

e17523 Background: The purpose of this study is to investigate the impact of organizational characteristics of the hospital on general health perception in postoperative primary breast cancer patients after discharge from hospital. Methods: Patients undergoing treatment for primary breast cancer in all certified breast centers in North Rhine-Westphalia (Germany) were invited to self-administer a questionnaire on health-related quality of life after discharge. Survey period was February to July 2007. 3,285 patients from 94 hospitals returned the questionnaire. The data were supplemented by disease and treatment characteristics reported by the oncologists (e.g. TNM-classification, type of surgery). Patient data were combined with information on hospital characteristics provided by hospital administrators. A multilevel analysis was applied to analyse the impact of organizational characteristics of the hospital (no. of annual breast cancer surgeries, breast care nurses employed, teaching hospital) on general health perception as reported by the breast cancer patients after discharge. Analyses were controlled for sociodemographic variables (age, marital status, education), type of surgery (mastectomy vs. BCT), and severity of disease (TNM-classification). Results: In the multilevel analysis performed organizational characteristics of the hospital do not contribute to patients’ general health after discharge. Only the variable “breast care nurses employed” is close to being positively associated with better general health at p < 0.05. In the model lymph node status (p < 0.05), metastases (p < 0.05), type of surgery (p < 0.01), age (p < 0.001), and education (p < 0.01) contribute to the explanation of the variance in general health perception. Conclusions: In the breast centers under investigation organizational characteristics of the hospital do not have an impact on primary breast cancer patients’ general health after hospital discharge. A possible reason is the high degree to which the treatment process itself is standardized. No significant financial relationships to disclose.