The impact of the type of hospital on survival of multiple myeloma patients: The MICORE study

2013 
Abstract Objective To analyze the impact of the type of hospital in overall survival of multiple myeloma patients. Patients and method A survival analysis was performed of all patients ( n  = 431) diagnosed in 5 public hospitals (4 community hospitals and one university hospital) during the period 1993–2006. Results Patients attended to in community hospitals differ significantly from those seen in the university hospital in the following variables: mean age (70 years [31–92] versus 67.9 (35–91), p  = .038); percentage of stage iii patients (62.6% versus 69.1%, p  = .033), and percentage of patients who had autologous stem cell transplant (8.2% versus 18.2%, p  = .026). The variables associated with mortality in the multivariate analysis were age ( p iii versus i ; p  = .03) and renal failure ( p  = .04). The type of hospital did not reach statistical significance (hazard ratio of 0.72 (95% confidence interval 0.48–1.07), p  = .1]. Conclusions The type of hospital is not significantly associated with mortality in multiple myeloma patients. These data support our current model of health care, in which the community hospitals are responsible for the primary care of these patients, in a coordinated work with the university hospital.
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