Table 3. Cox Model Predicting the Hazard of Mortality by Hospital Process Qualitya.
| Variables | Hazard Ratio (95% CI) | P Value |
|---|---|---|
| High-quality hospitalb | 0.93 (0.89-0.98) | .003 |
| Others | 1 [Reference] | |
| Lymph node ≥18 (patient level) | 0.85 (0.83-0.88) | <.001 |
| Negative margin (patient level) | 0.73 (0.71-0.76) | <.001 |
| Volume | ||
| Quartile 1 (lowest) | 1 [Reference] | |
| Quartile 2 | 1.08 (0.96-1.21) | .18 |
| Quartile 3 | 1.05 (0.95-1.17) | .34 |
| Quartile 4 (Highest) | 1.00 (0.90-1.11) | .97 |
| Hospital type | ||
| Community | 1 [Reference] | |
| Academic | 1.04 (1.01-1.08) | .02 |
| Integrated | 1.01 (0.95-1.08) | .73 |
a
Model includes sex, age, race, comorbidities, site, cN stage, pT stage, number of positive nodes, receipt of adjuvant therapy, extracapsular extension, insurance, income, education level, hospital volume, and hospital type. Head and neck cancers; data from the National Cancer Database, 2004 to 2013.
b
High-quality hospitals were defined as hospitals where patients had at least 80% compliance with lymph node counts of 18 or more and at least 90% compliance with negative margins.