Hospital safety-net burden does not predict differences in rectal cancer treatment and outcomes.
J Surg Res
; 221: 204-210, 2018 01.
Article
em En
| MEDLINE
| ID: mdl-29229129
ABSTRACT
BACKGROUND:
Safety-net hospitals have been shown to have inferior short-term surgical outcomes. The aim of this study was to compare rectal cancer management and survival across hospitals stratified by payer mix. MATERIALS ANDMETHODS:
Rectal cancer patients (n = 296,068) were identified using the 1998-2010 National Cancer Data Base. Hospitals were grouped into safety-net burden categories, according to the proportion of patients with Medicaid or no health insurance, as follows low-, medium-, and high-burden hospitals (HBHs). Patient and tumor characteristics, processes of care, and outcomes were evaluated, and regression analysis was used to investigate correlations between hospital safety-net burden on patient survival.RESULTS:
HBH encountered patients with more advanced disease (P < 0.001). Despite this, stage I-III patients at HBH had equal likelihood of receiving surgery and guideline-appropriate radiation and chemotherapy (all P > 0.05). The 30-day readmissions and mortality were also similar across safety-net groups (all P > 0.05). Multivariate analysis showed no difference in survival between HBH and low-burden hospital (P = 0.164).CONCLUSIONS:
Hospital payer mix may not adversely influence management of rectal cancer. This study highlights potential areas to improve cancer care for vulnerable patient populations.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Readmissão do Paciente
/
Neoplasias Retais
/
Provedores de Redes de Segurança
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Surg Res
Ano de publicação:
2018
Tipo de documento:
Article