Patient, hospital, and geographic disparities associated with comanagement during hospitalization for colorectal cancer surgery. Issue 4 (3rd February 2014)

• Record Type: Journal Article
• Authors: de Vries, Simone; Jeffe, Donna B.; Pruitt, Sandi L.; Davidson, Nicholas O.; Schootman, Mario
• Is Part Of: Journal of hospital medicine. Volume 9:Issue 4(2014)
• Page Start: 226
• Page End: 231
• Publication Date: 2014-02-03
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.1002/jhm.2161
• Languages: English
• ISSNs: 1553-5592

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jhm2161-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>Comanagement of surgical patients has increased, but information regarding detailed characteristics of patients receiving comanagement during hospitalization for colorectal cancer (CRC) surgery is lacking.</p> </sec> <sec id="jhm2161-sec-0002" sec-type="section"> <title>OBJECTIVE</title> <p>To examine the use of and characteristics associated with comanagement of patients hospitalized for CRC surgery.</p> </sec> <sec id="jhm2161-sec-0003" sec-type="section"> <title>DESIGN</title> <p>This study used a population‐based cross‐sectional design.</p> </sec> <sec id="jhm2161-sec-0004" sec-type="section"> <title>SETTING</title> <p>We used the linked 2000 to 2005 Surveillance, Epidemiology, and End Results and Medicare claims data.</p> </sec> <sec id="jhm2161-sec-0005" sec-type="section"> <title>PATIENTS</title> <p>We included 37, 065 patients aged 66 years or older, hospitalized for definitive CRC surgery following stage I to III diagnosis.</p> </sec> <sec id="jhm2161-sec-0006" sec-type="section"> <title>MEASUREMENTS</title> <p>The outcome of interest was comanagement during hospitalization for CRC surgery, and we examined the association between several patient and hospital characteristics. Comanagement was defined as having a relevant physician (ie, internal medicine hospitalist/generalist) submit a claim for evaluation and management services on 70% or more of the days of hospitalization of the patient.</p> </sec> <sec id="jhm2161-sec-0007" sec-type="section"> <title>RESULTS</title> <p>During hospitalization for CRC surgery, 27.6% of patients were comanaged, but this percentage varied widely across hospitals (from 1.9% to 83.2%). Several patient and hospital characteristics were associated with the use of comanaged care, of which important characteristics included older age at diagnosis, presence of comorbidity, emergency surgery, and hospital volume.</p> </sec> <sec id="jhm2161-sec-0008" sec-type="section"> <title>CONCLUSIONS</title> <p>Extensive variability existed in comanagement use across patients and hospitals, likely reflecting the lack of evidence for its clinical effectiveness. <italic>Journal of Hospital Medicine</italic> 2014;9:226–231. © 2014 Society of Hospital Medicine</p> </sec> </abstract>