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• W2313593297 abstract "In Brief Objective: To investigate hospital-level variation in short-term laparoscopic colectomy outcomes among stage I-III elderly colon cancer patients. Background: Surgical outcomes are associated with patient and surgeon characteristics. If outcomes are also impacted by the hospital where the surgery occurs, there is a hospital center effect (HCE). Methods: Surveillance, Epidemiology, and End Results (SEER)-Medicare data was used to identify stage I-III colon cancer patients treated with laparoscopic colectomies. Multilevel regressions were utilized to study potential HCE for length of stay (LOS), 30-day rehospitalization, and in-hospital mortality, adjusting for patient, surgeon, and hospital-level characteristics. To quantify HCE, we calculated the median instantaneous rate ratio (MIRR) for LOS and median odds ratio (MOR) for in-hospital mortality and 30-day rehospitalization. Sensitivity analyses were conducted for high volume/medical school affiliated hospitals and colorectal surgeons. Results: The multilevel analyses based on 4617 patients from 465 hospitals documented statistically significant HCEs for LOS (MIRR = 1.35; P < 0.001) and in-hospital mortality (MOR = 1.69; P = 0.032), but no HCE for 30-day rehospitalization. Sensitivity analyses confirmed our findings. HCE was significant for LOS in all sensitivity analyses and was significant for in-hospital mortality for high volume/medical school affiliated hospitals. Conclusions: HCE exists for LOS and in-hospital mortality of laparoscopic colectomy, which suggests that the choice of hospital affects outcomes independently of other confounding variables. Reducing the variation in outcomes associated with HCE may improve the quality of cancer care. This study investigates hospital-level variation in short-term surgical outcomes among elderly stage I-III colon cancer patients who undergo laparoscopic colectomy. Results suggest that the choice of hospital significantly impacts length of stay and in-hospital mortality. Reduction of this hospital center effect may improve the quality of cancer care." @default.
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• W2313593297 date "2014-05-01" @default.
• W2313593297 modified "2023-09-25" @default.
• W2313593297 title "Hospital Center Effect for Laparoscopic Colectomy Among Elderly Stage I-III Colon Cancer Patients" @default.
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• W2313593297 doi "https://doi.org/10.1097/sla.0b013e31829d0468" @default.
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