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Volume 18, Issue 11, Pages 1445-1453 (November 2017)
Effect of patient choice and hospital competition on service configuration and technology adoption within cancer surgery: a national, population-based study Dr Ajay Aggarwal, MD, Daniel Lewis, PhD, Prof Malcolm Mason, MD, Prof Arnie Purushotham, MD, Prof Richard Sullivan, MD, Prof Jan van der Meulen, PhD The Lancet Oncology Volume 18, Issue 11, Pages (November 2017) DOI: /S (17) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Terms and Conditions
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Figure 1 Flowchart of men included in the study
HES=Hospital Episode Statistics. NHS=UK National Health Service. The Lancet Oncology , DOI: ( /S (17) ) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Terms and Conditions
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Figure 2 Mobility patterns of patients receiving radical prostate cancer surgery at two selected NHS cancer centres Maps of the UK, illustrating the mobility pattern of patients who received radical prostate cancer surgery at two selected National Health Service (NHS) cancer centres (indicated with a + symbol in the area of core users) located in the east of England (A) and southwest England (B) that had a net gain of patients from outside their local area (ie, more arrivers than leavers). Both centres were established robotic centres. The maps include a scaled magnification of the region inset. Contains National Statistics data, © Crown copyright and database right 2017; NHS Research Scotland (NRS) data, © Crown copyright and database right 2017; Ordnance Survey data © Crown copyright and database right 2017; and Northern Ireland Statistics and Research Agency data. The Lancet Oncology , DOI: ( /S (17) ) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Terms and Conditions
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Figure 3 Net gains and losses of patients for each radical prostatectomy centre (n=65) during the study period Established robotic radical prostatectomy centres (n=12) shown in green and centres that closed during the 2010–14 study period (n=10) shown in red. Centres in blue are centres that were neither robotic radical prostectomy centres nor centres that closed during the study period. The Lancet Oncology , DOI: ( /S (17) ) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Terms and Conditions
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Figure 4 Effect of competition on the net gain or loss of patients for each radical prostatectomy centre during the study period The size of the circles corresponds to the number of men expected to have surgery at the centre. Red circles correspond to centres that closed during the study period (2010–14). Green circles correspond to established robotic centres. Blue circles correspond to centres that were neither robotic radical prostectomy centres nor centres that closed during the study period. Spatial competition index (SCI) score 0=hospital facing weakest competition. SCI score 1=hospital facing strongest competition. The Lancet Oncology , DOI: ( /S (17) ) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Terms and Conditions
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Figure 5 Changes in the number of robotic centres and total number of centres in the NHS in England (2009–17) The Lancet Oncology , DOI: ( /S (17) ) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Terms and Conditions
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