A tale of two cities: comparing lung cancer outcomes in Teesside, UK and Varese, Italy
- G A Silvestri1,
- M Peake2,
- D Waller3,
- S Spiro4
- 1Medical University of South Carolina, Charleston, SC 29425, USA
- 2LUCADA Project, Royal College of Physicians (London), Glenfield Hospital, Leicester LE3 9QP, UK
- 3Royal College of Physicians (London), Glenfield Hospital, Leicester LE3 9QP, UK
- 4University College London Hospitals, Middlesex Hospital, London, UK
- Correspondence to:
Dr G Silvestri
Medical University of South Carolina, Charleston, SC 29425, USA; silvestri{at}musc.edu
The study and publication of health outcomes has become increasingly common over the past decade. Providers of health care want assurance that they get what they pay for. In an increasingly consumer driven society, patients want to receive the best health care they can and feel they should have the opportunity to compare the performance of physicians and hospitals for any given illness. This can lead to the publication in the lay press of sensational articles which, for example, reveal that the mortality for heart bypass surgery is twice as high in one hospital as in another. Predictably, this is followed by physician outrage as they believe that their patients are somehow different, older, sicker, and at higher risk for a poor outcome. In some institutions the result is that surgeons no longer perform difficult cases for fear that they will be labelled as having poorer results. This may have had the unintentional consequence of less choice for patients.
Lost in this debate are the …
