Factors to consider when choosing a hospital include:
Many types of hospitals offer treatment for breast cancer and each can give excellent care.
The number of people treated at a hospital (hospital volume) may or may not be linked to the quality of breast cancer care in the United States. Some studies have shown the more breast cancer cases treated at a hospital each year, the better the care [2-3]. However, other studies have found no difference in survival among women treated at high volume hospitals and those treated at low volume hospitals [4-5].
Many hospitals use multidisciplinary teams to diagnose and treat breast cancer. In a team approach to care, all the health care providers involved in diagnosis and treatment meet as a group and coordinate care. This approach may provide better care by increasing communication between providers and decreasing the time between diagnosis and treatment. The National Accreditation Program for Breast Centers is working to improve quality of care in medical centers that offer multidisciplinary breast cancer care.
At this time, there is not enough information on the benefits of a multidisciplinary team approach to recommend it over the standard care currently received at most hospitals.
The type of hospital you choose depends on many factors. Besides quality care, transportation and insurance coverage can also play a role in your decision.
NCI-designated Cancer Centers and academic centers tend to be located in larger cities. This can make travel to and from treatment difficult if you live far away.
Another factor is cost. Not all physicians and medical centers are covered by all health insurance plans. With the high cost of breast cancer treatment, you may prefer care from the providers and centers covered under your health insurance plans.
Finally, if you have already chosen a physician, the choice of hospitals will be limited to those where he/she has practicing privileges.
When choosing a hospital, no single source gives a perfect measure of quality. However, combining information from several sources (listed below) can help you make an informed decision.
Referrals from trusted sources, such as your primary care physician, family, friends or other breast cancer survivors, are often the best way to find a good hospital.
Visiting a hospital before treatment begins lets you get a feel for the facility. Is the staff nice and helpful? Is the building well kept? Are the waiting areas, restrooms and lobby clean? These factors can be important in your decision-making.
Visiting a site beforehand also helps you learn how easy it is to get to and from your home. You can also find out what lodging is available.
A number of organizations in the United States monitor the quality of medical centers. Their ratings can be a good sign of the quality of care given by a center.
The Joint Commission. The Joint Commission conducts site visits and audits of hospitals and surgery centers to check the quality of their care. It gives ratings based on performance. To find a healthcare organization that meets safety and quality standards, visit The Joint Commission's website or call (630) 792-5800.
Commission on Cancer of the American College of Surgeons. The Commission on Cancer evaluates hospital cancer programs against a set of quality standards, similar to the Joint Commission. To search for an accredited cancer program near you, visit the American College of Surgeon’s website.
Food and Drug Administration (FDA). The FDA, through the Mammography Quality Standards Act, oversees the licensing of mammography centers. A list of centers meeting the FDA's quality standards is available online or by calling the National Cancer Institute's Cancer Information Service at (800) 4-CANCER.
Each year, the FDA produces a Mammography Facility Adverse Event Report, detailing any actions taken against specific mammography centers.
Publications that rate the "best" hospitals can be a good resource. For example, US News & World Report publishes “America's Best Hospitals” each year (view their most recent hospital honor roll). While such publications are often based on extensive research and are useful guides, they should not be the sole basis for choosing a hospital.
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