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2010 Annual Meeting Abstracts

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Regional patterns of pancreatic cancer care in Massachusetts
*Jillian K Smith, *Melissa M Murphy, *James E Carroll, *Shimul A Shah, *Theodore P McDade, Jennifer F Tseng
UMass Medical School, Worcester, MA

Objective:
To analyze geographic patterns of pancreatic cancer resection in Massachusetts.
Background:
Volume-outcome relationships and learning curves for diseases such as pancreatic cancer exist. Regionalization has been proposed for complex cases such as pancreatectomy. However, regionalization may generate barriers, e.g. limitations of expeditious emergency care or disparities in ability to travel.
Design:
Retrospective database.
Setting:
Massachusetts Community Health Information Profile (MassCHIP), 2000-2008; Massachusetts Health Care Quality and Cost Information, 2005.
Patients:
Massachusetts residents ≥18 years with pancreatic cancer.
Interventions:
Pancreatic resection identified in database review.
Main Outcome Measures:
Trends in pancreatic resections.
Results:
Over 2000-2008, the number of pancreatic resections performed in Massachusetts increased from a low of 270 in 2001 to 392 in 2008 (Figure 1). 7 academic centers in Massachusetts performed ≥10 pancreatic resections in 2005; 4 of these centers are located within one county, Suffolk (Boston metropolitan area). Over the time course of this study, increasing regionalization of pancreatic cancer resection occurred. For example, in the latest year with complete county data (2005), 86% of pancreatectomies were performed in Suffolk, which represented only 18% of incident pancreatic cancers (Figure 2).
Conclusions:
Number of pancreatic resections performed in Massachusetts is steadily increasing. Patterns of resections and incidence suggest a regionalization of pancreatic cancer care. Investigations examining these patterns over time as well as distance travelled by patients to achieve this regionalization are underway.


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