It is important to choose a top-quality institution for the treatment of cancer, whether inpatient or outpatient. Choice of such an institution might have a big effect on the long-term outcome.

The types of cases used in our calculation of risk-adjusted death rates did not include cases in which cancer was the diagnosis listed as the primary reason for hospital admission. Calculating risk-adjusted death rates is not as meaningful for cancer cases as for many other types of cases. Often, what the hospital does can have little or no effect on whether the patient dies within 90 days after hospital admission, which is the period for which the hospital death rates were calculated. The death from cancer may be unavoidable, and the hospital’s efforts may be focused on pain reduction or treatment of secondary problems. Some hospitals may have a higher proportion of advanced cancer cases than other hospitals have, depending in part on community customs and resources for treating such cases in nursing homes, hospices, or other settings.

Nonetheless, it is important to choose a top-quality institution for the treatment of cancer, whether inpatient or outpatient. Choice of such an institution might have a big effect on the long-term outcome.

One indication of an institution’s competence in the treatment of cancer is designation by the National Cancer Institute (NCI) as a Comprehensive Cancer Center or a Clinical Cancer Center. This designation is given to major academic and research institutions throughout the United States with broad-based, coordinated, interdisciplinary programs in cancer research. These institutions have been selected by NCI for scientific excellence and capability to integrate a diversity of research approaches to focus on the problem of cancer. In addition to doing research, the institutions also treat patients.

A further indication of an institution’s competence in treating cancer is membership in the National Comprehensive Cancer Network (NCCN). NCCN is a not-for-profit alliance of leading cancer centers. It seeks to help member institutions to do excellent research, measure the outcomes of the care they provide, and provide state-of-the-art cancer care to as many patients as possible.