EDIT: tl;dr

Two registry cohort papers on breast cancer outcomes, one only in Los Angeles county "provide extensive evidence for my claim"

The claim: For the overwhelming majority of things people to go to the hospital for, where you go doesn't really matter.

Ok, whatever.

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somenameforme 2 days ago | parent [-]

This is not anecdotal. At least for the cancer we're discussing, breast cancer, there is no meaningful difference between hospitals. Here [1] is a study on this exact question for breast cancer.

They covered an extensive number of variables across hospitals and patients (including NCI/ACS status). They found no correlation with improved survival rates for any variable except for black women receiving their initial treatment at an ACS hospital. While that is technically an affirmation of your claims, I think it is clearly suggestive of some form of bias rather than being a clear causal association.

[1] - https://pmc.ncbi.nlm.nih.gov/articles/PMC8462568/

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epcoa 2 days ago | parent [-]

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somenameforme 2 days ago | parent [-]

I said for the overwhelming majority of things people go to the hospital for. And the overwhelming majority would be things far more commoditized than cancer - stomach aches, injuries, fevers, infections, cardiovascular issues, etc. I chose breast cancer because it is the most common type of cancer and at the extreme fringes of my what comment might cover. It just so happens that my comment does cover it as well.

Incidentally, it's also the same story for colorectal cancer, the 2nd most common type of cancer. Here's another study on the topic. [1] They have a survival rate of 88.6 vs 85.9 for breast cancer, but it's a large observational study that's not normalized, so the confounders/biases there probably explain the reduction in survival rate at non-NIC hospitals. Colorectal cancer is even smaller - 0.2%.

NIC hospitals only showed a significant effect on cancers with low survival rates, and especially on rarer cancers. For instance with pancreatic cancer 93.8% of people who went to a non-NIC hospital were dead in 5 years, by contrast 'only' 87.5% of NIC hospital patients were. Feel free to look up the data yourself. I'm not searching for cherry picked studies, there are none - as there seem to be oddly few studies on this question, and they all say the same thing. What benefit there is is quite small, and heavily driven by extremely rare things.

[1] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4892698/

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epcoa 2 days ago | parent [-]

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somenameforme 2 days ago | parent [-]

Feel free to find a single study that you think supports your position. I've provided extensive evidence for my claims which you want to claim is insufficient or somehow cherry picked. You've provided nothing, and are now relying exclusively on ad hominem.

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epcoa 2 days ago | parent | next [-]

Two registry cohort papers on breast cancer outcomes, one only in Los Angeles county "provide extensive evidence for my claims"

The claim: For the overwhelming majority of things people to go to the hospital for, where you go doesn't really matter.

You win, as always.

https://news.ycombinator.com/item?id=45199654

	▲	somenameforme a day ago \| parent [-]
		You chose to take us down the path of cancer, not entirely unreasonable as I mentioned it. But it is clearly in the fringe extremes of my argument since it is one disease where, ostensibly, specialized care could really pay off. But it turns out that even in the case of cancer, the benefit of specialized care (for the most cancers at least) is small to zero. If your local hospital can treat e.g. colorectal or breast cancer to the same degree as a specialized institution, then they can certainly competently treat the overwhelming majority of other issues that people show up to the hospital with, which are generally going to be substantially more mundane with rather more 'commoditized' treatment available.

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2 days ago | parent | prev [-]

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