TY - JOUR
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 O.
AU - Martindale, Robert G.
AU - Sheppard, Brett C.
AU - Lu, Kim C.
AU - Tsikitis, V. Liana
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/7
Y1 - 2018/7
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.
KW - Medicare provider analysis and review (MEDPAR)
KW - Patient entitlement and diagnosis summary file (PEDSF)
KW - Surveillance, epidemiology and end results (SEER)-medicare linked database
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U2 - 10.1016/j.jss.2018.02.022
DO - 10.1016/j.jss.2018.02.022
M3 - Article
C2 - 29804856
AN - SCOPUS:85044024734
SN - 0022-4804
VL - 227
SP - 220
EP - 227
JO - Journal of Surgical Research
JF - Journal of Surgical Research
ER -