Comparing survival outcomes for patients with colorectal cancer treated in public and private hospitals.

OBJECTIVE To determine whether treatment in a private versus public hospital was an independent predictor of survival outcomes in patients with colorectal cancer. DESIGN Retrospective, population-based study. SETTING Tertiary care hospitals. PARTICIPANTS All patients diagnosed with colorectal cancer in Western Australia between 1993 and 2003. INTERVENTIONS Management in private versus public hospitals. MAIN OUTCOME MEASURES Overall survival and cancer-specific survival rates. RESULTS 5809 patients were treated for colorectal cancer. Of these, 1523 (26%) were managed in private hospitals. The 5-year overall survival rates for private and public hospital patients were 59.4% (95% CI, 56.9%-61.9%) and 48.6% (95% CI, 47.0%-50.2%), respectively. Significant independent predictors of overall survival were: treatment in a private hospital (P = 0.0001; relative risk [RR], 0.764; 95% CI, 0.696-0.839); younger age (P = 0.0001; RR, 1.032; 95% CI, 1.029-1.036); male sex (P = 0.001; RR, 1.148; 95% CI, 1.068-1.234); and cancer stage (eg, Stage II: P = 0.0001; RR, 1.508; 95% CI, 1.316-1.729). CONCLUSIONS Treatment in a private hospital was a significant independent predictor of survival outcomes. Further validation of these results would have a significant bearing on how we approach health care delivery for patients with colorectal cancer.