Travel distance influences readmissions in colorectal cancer patients—what the primary operative team needs to know

Katherine A. Kelley, J. Isaac Young, Solange Bassale, Daniel Herzig, Robert Martindale, Brett Sheppard, Kim Lu, Vassiliki Tsikitis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Many colorectal cancer patients receive complex surgical care remotely. We hypothesized that their readmission rates would be adversely affected after accounting for differences in travel distance from primary/index hospital and correlate with mortality. Materials and methods: We identified 48,481 colorectal cancer patients in the Surveillance, Epidemiology and End Results (SEER)-Medicare database. Travel distance was calculated, using Google Maps, and SAS. Multivariate negative binomial regression was used to identify factors associated with readmission rates. Overall survival was analyzed, using Kaplan–Meier and Cox proportional hazard. Results and conclusions: Thirty-day readmissions occurred in 14.9% of the cohort, 27.5% of which were to a nonindex hospital. In the colon and rectal cancer cohorts, readmissions were 14.5% and 16.5%, respectively. Rectal cancer patients had an increase in readmission by 13% (incidence rate ratios [IRR] 1.13; 95% confidence interval [CI] 1.05-1.21). Factors associated with readmission were male gender, advanced disease, length of stay (LOS), discharge disposition, hospital volume, Charlson score, and poverty level (P < 0.05). Greater distance traveled increased the likelihood of readmission but did not affect mortality. Travel distance influences readmission rates but not mortality. Discharge readiness to decrease readmissions is essential for colorectal cancer patients discharged from index hospitals.

Original languageEnglish (US)
Pages (from-to)220-227
Number of pages8
JournalJournal of Surgical Research
Volume227
DOIs
StatePublished - Jul 1 2018

Fingerprint

Colorectal Neoplasms
Rectal Neoplasms
Mortality
Poverty
Medicare
Colonic Neoplasms
Length of Stay
Epidemiology
Databases
Confidence Intervals
Survival
Incidence

Keywords

  • Medicare provider analysis and review (MEDPAR)
  • Patient entitlement and diagnosis summary file (PEDSF)
  • Surveillance, epidemiology and end results (SEER)-medicare linked database

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Travel distance influences readmissions in colorectal cancer patients—what the primary operative team needs to know",
abstract = "Background: Many colorectal cancer patients receive complex surgical care remotely. We hypothesized that their readmission rates would be adversely affected after accounting for differences in travel distance from primary/index hospital and correlate with mortality. Materials and methods: We identified 48,481 colorectal cancer patients in the Surveillance, Epidemiology and End Results (SEER)-Medicare database. Travel distance was calculated, using Google Maps, and SAS. Multivariate negative binomial regression was used to identify factors associated with readmission rates. Overall survival was analyzed, using Kaplan–Meier and Cox proportional hazard. Results and conclusions: Thirty-day readmissions occurred in 14.9{\%} of the cohort, 27.5{\%} of which were to a nonindex hospital. In the colon and rectal cancer cohorts, readmissions were 14.5{\%} and 16.5{\%}, respectively. Rectal cancer patients had an increase in readmission by 13{\%} (incidence rate ratios [IRR] 1.13; 95{\%} confidence interval [CI] 1.05-1.21). Factors associated with readmission were male gender, advanced disease, length of stay (LOS), discharge disposition, hospital volume, Charlson score, and poverty level (P < 0.05). Greater distance traveled increased the likelihood of readmission but did not affect mortality. Travel distance influences readmission rates but not mortality. Discharge readiness to decrease readmissions is essential for colorectal cancer patients discharged from index hospitals.",
keywords = "Medicare provider analysis and review (MEDPAR), Patient entitlement and diagnosis summary file (PEDSF), Surveillance, epidemiology and end results (SEER)-medicare linked database",
author = "Kelley, {Katherine A.} and Young, {J. Isaac} and Solange Bassale and Daniel Herzig and Robert Martindale and Brett Sheppard and Kim Lu and Vassiliki Tsikitis",
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T1 - Travel distance influences readmissions in colorectal cancer patients—what the primary operative team needs to know

AU - Kelley, Katherine A.

AU - Young, J. Isaac

AU - Bassale, Solange

AU - Herzig, Daniel

AU - Martindale, Robert

AU - Sheppard, Brett

AU - Lu, Kim

AU - Tsikitis, Vassiliki

PY - 2018/7/1

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N2 - Background: Many colorectal cancer patients receive complex surgical care remotely. We hypothesized that their readmission rates would be adversely affected after accounting for differences in travel distance from primary/index hospital and correlate with mortality. Materials and methods: We identified 48,481 colorectal cancer patients in the Surveillance, Epidemiology and End Results (SEER)-Medicare database. Travel distance was calculated, using Google Maps, and SAS. Multivariate negative binomial regression was used to identify factors associated with readmission rates. Overall survival was analyzed, using Kaplan–Meier and Cox proportional hazard. Results and conclusions: Thirty-day readmissions occurred in 14.9% of the cohort, 27.5% of which were to a nonindex hospital. In the colon and rectal cancer cohorts, readmissions were 14.5% and 16.5%, respectively. Rectal cancer patients had an increase in readmission by 13% (incidence rate ratios [IRR] 1.13; 95% confidence interval [CI] 1.05-1.21). Factors associated with readmission were male gender, advanced disease, length of stay (LOS), discharge disposition, hospital volume, Charlson score, and poverty level (P < 0.05). Greater distance traveled increased the likelihood of readmission but did not affect mortality. Travel distance influences readmission rates but not mortality. Discharge readiness to decrease readmissions is essential for colorectal cancer patients discharged from index hospitals.

AB - Background: Many colorectal cancer patients receive complex surgical care remotely. We hypothesized that their readmission rates would be adversely affected after accounting for differences in travel distance from primary/index hospital and correlate with mortality. Materials and methods: We identified 48,481 colorectal cancer patients in the Surveillance, Epidemiology and End Results (SEER)-Medicare database. Travel distance was calculated, using Google Maps, and SAS. Multivariate negative binomial regression was used to identify factors associated with readmission rates. Overall survival was analyzed, using Kaplan–Meier and Cox proportional hazard. Results and conclusions: Thirty-day readmissions occurred in 14.9% of the cohort, 27.5% of which were to a nonindex hospital. In the colon and rectal cancer cohorts, readmissions were 14.5% and 16.5%, respectively. Rectal cancer patients had an increase in readmission by 13% (incidence rate ratios [IRR] 1.13; 95% confidence interval [CI] 1.05-1.21). Factors associated with readmission were male gender, advanced disease, length of stay (LOS), discharge disposition, hospital volume, Charlson score, and poverty level (P < 0.05). Greater distance traveled increased the likelihood of readmission but did not affect mortality. Travel distance influences readmission rates but not mortality. Discharge readiness to decrease readmissions is essential for colorectal cancer patients discharged from index hospitals.

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