Annals of Surgical Oncology

, Volume 26, Issue 3, pp 732–738 | Cite as

Why Travel for Complex Cancer Surgery? Americans React to ‘Brand-Sharing’ Between Specialty Cancer Hospitals and Their Affiliates

  • Alexander S. Chiu
  • Benjamin Resio
  • Jessica R. Hoag
  • Andres F. Monsalve
  • Justin D. Blasberg
  • Lawrence Brown
  • Audrey Omar
  • Marney A. White
  • Daniel J. BoffaEmail author
Health Services Research and Global Oncology



Leading cancer hospitals have increasingly shared their ‘brand’ with smaller hospitals through affiliations. Because each brand evokes a distinct reputation for the care provided, ‘brand-sharing’ has the potential to impact the public’s ability to differentiate the safety and quality within hospital networks. The general public was surveyed to determine the perceived similarities and differences in the safety and quality of complex cancer surgery performed at top cancer hospitals and their smaller affiliate hospitals.


A national, web-based KnowledgePanel (GfK) survey of American adults was conducted. Respondents were asked about their beliefs regarding the quality and safety of complex cancer surgery at a large, top-ranked cancer hospital and a smaller, local hospital, both in the presence and absence of an affiliation between the hospitals.


A total of 1010 surveys were completed (58.1% response rate). Overall, 85% of respondents felt ‘motivated’ to travel an hour for complex surgery at a larger hospital specializing in cancer, over a smaller local hospital. However, if the smaller hospital was affiliated with a top-ranked cancer hospital, 31% of the motivated respondents changed their preference to the smaller hospital. When asked to compare leading cancer hospitals and their smaller affiliates, 47% of respondents felt that surgical safety, 66% felt guideline compliance, and 53% felt cure rates would be the same at both hospitals.


Approximately half of surveyed Americans did not distinguish the quality and safety of surgical care at top-ranked cancer hospitals from their smaller affiliates, potentially decreasing their motivation to travel to top centers for complex surgical care.

Supplementary material

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Supplementary material 1 (DOCX 17 kb)


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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Alexander S. Chiu
    • 1
  • Benjamin Resio
    • 1
  • Jessica R. Hoag
    • 2
  • Andres F. Monsalve
    • 1
  • Justin D. Blasberg
    • 3
  • Lawrence Brown
    • 3
  • Audrey Omar
    • 4
  • Marney A. White
    • 5
    • 6
  • Daniel J. Boffa
    • 2
    • 3
    Email author
  1. 1.Department of SurgeryYale School of MedicineNew HavenUSA
  2. 2.Cancer Outcomes, Public Policy, and Effectiveness Research CenterYale School of MedicineNew HavenUSA
  3. 3.Section of Thoracic Surgery, Department of SurgeryYale University School of MedicineNew HavenUSA
  4. 4.Yale Center for Analytic SciencesYale School of MedicineNew HavenUSA
  5. 5.Department of Social and Behavioral SciencesYale School of Public HealthNew HavenUSA
  6. 6.Department of PsychiatryYale School of MedicineNew HavenUSA

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