TY - JOUR
T1 - Rurality and cancer surgery in the United States
AU - Markin, Abraham
AU - Habermann, Elizabeth B.
AU - Chow, Christopher J.
AU - Zhu, Yanrong
AU - Vickers, Selwyn M.
AU - Al-Refaie, Waddah B.
N1 - Funding Information:
Supported by the 2008 Veterans of Foreign Wars and its Ladies Auxiliary Surgical Oncology Research Award, the Enhancing Minority Participation in Clinical Trials ( EMPaCT ; 5RC2MD004797-02 ) grant, and by the Center for Health Equity, funded by the National Institute for Minority Health Disparities 1P60MD003422 .
PY - 2012/11
Y1 - 2012/11
N2 - Background: Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. Methods: We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed using the 1998 to 2009 Nationwide Inpatient Sample. Logistic regression examined predictors of rurality and the adjusted likelihood of in-hospital mortality at rural and urban hospitals. Results: The fraction of procedures performed at rural hospitals decreased from 12% to 6%. Older age, non-Hispanic white race, and fewer comorbidities predicted rurality. Rural hospitals did not have worse mortality, however, rurality significantly augmented mortality among recipients of complex cancer surgery. Conclusions: Rural hospitals had comparable mortality overall, but delivered poorer outcomes for certain groups. Future research should explore these variations as cancer care is increasingly centralized.
AB - Background: Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. Methods: We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed using the 1998 to 2009 Nationwide Inpatient Sample. Logistic regression examined predictors of rurality and the adjusted likelihood of in-hospital mortality at rural and urban hospitals. Results: The fraction of procedures performed at rural hospitals decreased from 12% to 6%. Older age, non-Hispanic white race, and fewer comorbidities predicted rurality. Rural hospitals did not have worse mortality, however, rurality significantly augmented mortality among recipients of complex cancer surgery. Conclusions: Rural hospitals had comparable mortality overall, but delivered poorer outcomes for certain groups. Future research should explore these variations as cancer care is increasingly centralized.
KW - Cancer treatment
KW - Outcomes
KW - Patterns of care
KW - Rural health care
KW - Surgical oncology
UR - http://www.scopus.com/inward/record.url?scp=84868573879&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84868573879&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2012.07.012
DO - 10.1016/j.amjsurg.2012.07.012
M3 - Article
C2 - 22906250
AN - SCOPUS:84868573879
SN - 0002-9610
VL - 204
SP - 569
EP - 573
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 5
ER -