Inequalities in XXXX treatment and mortality.

@entity1 @entity1149 @entity5 @entity2
BACKGROUND: @entity1149 ( @entity1149 ) comprises approximately 85% of all @entity2 cases, and surgery is the preferred treatment for @entity1 . The National Health Service established Primary Care Trusts (PCTs) in 2002 to manage local health needs. We investigate whether PCTs with a lower uptake of surgical treatment are those with above-average mortality 1   year after diagnosis. The applied methods can be used to monitor the performance of any administrative bodies responsible for the management of @entity1 with @entity5 . METHODS: All adults diagnosed with @entity2 during 1998-2006 in England were identified. We fitted mixed effect logistic models to predict surgical treatment within 6   months after diagnosis, and mortality within 1   year of diagnosis. RESULTS: Around 10% of the NCSLC @entity1 received curative surgery. Older deprived @entity1 and those who did not receive surgery had much higher odds of death 1   year after being diagnosed with @entity5 . In total, 69% of the PCTs were below the lower control limit of surgery and have predicted random intercepts above the mean value of zero of the random effect for mortality, whereas 40% were above the upper control limit of mortality within 1   year. CONCLUSIONS: Our main results suggest the presence of clear geographical variation in the use of surgical treatment of @entity1149 and mortality. Mixed-effects models combined with the funnel plot approach were useful for assessing the performance of PCTs that were above average in mortality and below average in surgery.
