Table 1:
Center characteristics
| Characteristic | Center volume* |
||
|---|---|---|---|
| ≤ 40 alloHCT N (%) | > 40 alloHCT N (%) | P-Value | |
| Number of centers | 42 | 41 | |
| Affiliation with teaching hospital | 0.020 | ||
| No | 12 (28.6) | 3 (7.3) | |
| Yes | 30 (71.4) | 38 (92.7) | |
| Ownership status | 0.214 | ||
| Government | 14 (33.3) | 8 (19.5) | |
| Private | 28 (66.7) | 33 (80.5) | |
| Hospital size (inpatient beds) | 0.043 | ||
| <500 | 18 (42.9) | 12 (29.3) | |
| 500–999 | 19 (45.2) | 23 (56.1) | |
| ≥1000 | 5 (11.9) | 6 (14.6) | |
| NCI Comprehensive Cancer Center | 0.001 | ||
| No | 31 (73.8) | 15 (36.6) | |
| Yes | 11 (26.2) | 26 (63.4) | |
| EHR in inpatient and/or outpatient area | 0.676 | ||
| No | 4 (9.5) | 2 (4.9) | |
| Yes | 38 (90.5) | 39 (95.1) | |
| Inpatient beds exclusively dedicated to HCT | 0.324 | ||
| No | 3 (7.1) | 3 (7.3) | |
| Yes | 39 (92.9) | 38 (92.7) | |
| Separate outpatient clinic for HCT patients | 0.359 | ||
| No | 17 (40.5) | 12 (29.3) | |
| Yes | 25 (59.5) | 29 (70.7) | |
| Stem cell processing lab on site/campus | 0.156 | ||
| No | 7 (16.7) | 2 (4.9) | |
| Yes | 35 (83.3) | 39 (95.1) | |
| FACT accreditation for allogeneic HCT | 0.055 | ||
| No | 5 (11.9) | 0 | |
| Yes | 37 (88.1) | 41 (100.0) | |
| Participation in cooperative group clinical trials | 0.007 | ||
| No | 12 (28.6) | 2 (4.9) | |
| Yes | 30 (71.4) | 39 (95.1) | |
| Patients enrolled on IRB approved protocols | 0.016 | ||
| None | 4 (9.5) | 0 | |
| <25% | 20 (47.6) | 14 (34.2) | |
| 25–49% | 7 (16.7) | 18 (43.9) | |
| ≥50% | 11 (26.2) | 9 (22.0) | |
| Affiliated with hematology-oncology fellowship program | 0.006 | ||
| No | 14 (33.3) | 3 (7.3) | |
| Yes | 28 (66.7) | 38 (92.7) | |
| Long-term follow-up or survivorship program | 0.359 | ||
| No | 30 (71.4) | 25 (61.0) | |
| Yes | 12 (28.6) | 16 (39.0) | |
| Graft-versus-host disease clinic | 0.049 | ||
| No | 38 (90.5) | 30 (73.2) | |
| Yes | 4 (9.5) | 11 (26.8) | |
| Average inpatient nurse-patient ratio | 0.048 | ||
| ≤1:2 | 15 (35.7) | 5 (12.2) | |
| 1:3 | 22 (52.4) | 29 (70.7) | |
| ≥1:4 | 5 (11.9) | 7 (17.1) | |
| FTE transplant clinical coordinators | <0.001 | ||
| ≤1 | 8 (19.1) | 1 (2.4) | |
| 2–3 | 28 (66.7) | 8 (19.5) | |
| 4–6 | 6 (14.3) | 23 (56.1) | |
| ≥7 | 0 | 9 (22.0) | |
| FTE pharmacists | <0.001 | ||
| ≤1 | 27 (64.3) | 7 (17.1) | |
| 2–3 | 14 (33.3) | 26 (63.4) | |
| ≥4 | 1 (2.4) | 8 (19.5) | |
| FTE psychosocial clinicians | <0.001 | ||
| ≤1 | 26 (61.9) | 5 (12.2) | |
| 2–3 | 16 (38.1) | 28 (68.3) | |
| ≥4 | 0 | 8 (19.5) | |
| Median number of attending physicians (IQR) | 4 (3–5) | 8 (6–12) | |
| Median number of APPs (IQR) | 2 (1–5) | 8 (5–14) | |
| Clinical effort of majority of HCT physicians | 0.007 | ||
| See HCT patients only | 7 (16.7) | 14 (34.2) | |
| See HCT and hematologic oncology patients | 28 (66.7) | 27 (65.9) | |
| See HCT and general oncology patients | 7 (16.7) | 0 | |
| Provider responsible for after hour calls | 0.652 | ||
| Attending physician | 23 (54.8) | 27 (65.9) | |
| Fellow | 14 (33.3) | 10 (24.4) | |
| Other providers (e.g., hospitalists, APPs) | 5 (11.9) | 4 (9.8) | |
| Primary team for patients on ventilator | 0.700 | ||
| HCT team | 3 (7.1) | 4 (9.8) | |
| Critical care team | 15 (35.7) | 11 (26.8) | |
| Co-managed by HCT and critical care teams | 24 (57.1) | 26 (63.4) | |
| Primary unit for ventilator patients | 0.183 | ||
| HCT unit | 6 (14.3) | 11 (26.8) | |
| Critical care unit | 36 (85.7) | 30 (73.2) | |
| Physician care model in first 100 days | 0.013 | ||
| Same physician inpatient and outpatient | 10 (23.8) | 1 (2.4) | |
| >1 physician inpatient and same outpatient | 22 (52.4) | 29 (70.7) | |
| >1 physician inpatient and outpatient | 10 (23.8) | 11 (26.8) | |
| Outpatient care model till day 100 for most patients | 0.133 | ||
| Seen by attending physician | 24 (57.1) | 23 (56.1) | |
| Seen by APPs and staffed with physician | 18 (42.9) | 14 (34.2) | |
| Seen by APPs independently | 0 | 4 (9.8) | |
| Discharge practice for most patients without complications | 0.712 | ||
| Varies from provider to provider | 25 (59.5) | 25 (61.0) | |
| Co-followed with referring oncologist | 8 (19.1) | 10 (24.4) | |
| Patients are not discharged from transplant center | 9 (21.4) | 6 (14.6) | |
Abbreviations: HCT – hematopoietic cell transplantation; NCI – National Cancer Institute; EHR – electronic health record; FACT: Foundation for the Accreditation of Cellular Therapy; IRB – Institutional Review Board; IQR – interquartile range; APPs – advanced practice providers; FTE – full time equivalent
*
Based on allogeneic hematopoietic cell transplant volume reported to the CIBMTR in 2010