TABLE 1.
Characteristics of Medicare beneficiaries discharged after colectomy for cancer (n = 42,348). Abbreviations: HCC, Hierarchical Condition Categories; SNF, skilled nursing facility.
| Characteristic | All Patients (n=42,348), % | Non- Readmitted (n=37,686), % | Readmitted (n=4,662), % | p-value |
|---|---|---|---|---|
| Patient-related | ||||
| Age, mean (SD) | 78.0 (6.9) | 77.8 (6.9) | 78.9 (7.1) | < 0.001 |
| Female gender | 58.5 | 58.9 | 55.5 | < 0.001 |
| Race/ethnicity | ||||
| White | 86.3 | 86.5 | 84.9 | 0.021 |
| Black | 6.0 | 5.9 | 7.0 | |
| Asian or Pacific Islander | 4.1 | 4.1 | 4.4 | |
| Hispanic | 3.1 | 3.1 | 3.4 | |
| Other | 0.4 | 0.4 | 0.3 | |
| Marital status | 0.005 | |||
| Married | 49.9 | 50.2 | 47.4 | |
| Widowed | 35.6 | 35.4 | 37.4 | |
| Single, Separated, or Divorced | 11.2 | 11.1 | 11.6 | |
| Unknown | 3.3 | 3.3 | 3.6 | |
| Median household income, $, mean (SD) | 38,477 (17,319) | 38,601 (17,400) | 37,445 (16,595) | < 0.001 |
| Less than 12y edu, %, mean (SD) | 20.3 (12.3) | 20.2 (12.3) | 21.2 (12.5) | < 0.001 |
| SEER Registry | < 0.001 | |||
| California | 28.5 | 28.7 | 27.2 | |
| Connecticut | 11.7 | 11.8 | 10.8 | |
| Detroit | 11.6 | 11.5 | 12.6 | |
| Hawaii | 1.9 | 2.0 | 1.8 | |
| Iowa | 14.6 | 14.7 | 14.4 | |
| New Mexico | 2.6 | 2.7 | 2.4 | |
| Seattle | 8.1 | 8.2 | 7.6 | |
| Utah | 3.2 | 3.2 | 3.1 | |
| Atlanta & Rural Georgia | 4.4 | 4.4 | 4.4 | |
| Kentucky | 3.4 | 3.4 | 4.2 | |
| Louisiana | 2.9 | 2.8 | 3.7 | |
| New Jersey | 7.0 | 6.9 | 8.0 | |
| Residence location | 0.15 | |||
| Major metropolitan | 56.2 | 56.2 | 56.9 | |
| Metropolitan or urban | 33.7 | 33.9 | 32.6 | |
| Less urban or rural | 10.1 | 10.0 | 10.6 | |
| HCC comorbidity score, mean (SD) | 2.1 (1.4) | 2.1 (1.3) | 2.6 (1.5) | < 0.001 |
| Hospitalized in the year before surgery | 25.9 | 24.9 | 34.5 | < 0.001 |
| Disease-related | ||||
| Cancer stage | < 0.001 | |||
| I | 24.0 | 24.3 | 22.2 | |
| II | 44.4 | 44.4 | 44.4 | |
| III | 31.5 | 31.3 | 33.4 | |
| Tumor grade | 0.002 | |||
| Well-differentiated | 9.1 | 9.1 | 9.2 | |
| Moderately-differentiated | 66.1 | 66.3 | 64.8 | |
| Poorly or undifferentiated | 20.6 | 20.4 | 22.5 | |
| Unknown | 4.2 | 4.2 | 3.6 | |
| Emergent admission | 17.4 | 16.7 | 23.4 | < 0.001 |
| Intestinal obstruction on admission | 3.9 | 3.9 | 4.3 | 0.141 |
| Intestinal perforation on admission | 1.8 | 1.8 | 2.4 | 0.002 |
| Treatment-related | ||||
| Year of surgery | ||||
| 1992–1995 | 30.9 | 31.3 | 27.5 | < 0.001 |
| 1996–1999 | 28.7 | 28.7 | 28.7 | |
| 2000–2002 * | 40.4 | 40.0 | 43.7 | |
| Hospital procedure volume | < 0.001 | |||
| 1st tertile (lowest volume) | 36.2 | 35.8 | 39.4 | |
| 2nd tertile | 31.3 | 21.4 | 30.0 | |
| 3rd tertile | 32.6 | 32.8 | 30.7 | |
| Surgeon procedure volume | 0.279 | |||
| 1st tertile (lowest volume) | 34.9 | 34.8 | 36.0 | |
| 2nd tertile | 35.5 | 35.5 | 35.1 | |
| 3rd tertile | 29.6 | 29.7 | 29.0 | |
| Laparoscopic surgery | 0.6 | 0.6 | 0.7 | 0.753 |
| Length of hospital stay, mean (SD) | 11.2 (6.9) | 11.0 (6.5) | 13.3 (9.0) | < 0.001 |
| Received blood transfusion | 17.5 | 16.9 | 21.9 | < 0.001 |
| Stoma | 8.3 | 8.0 | 11.0 | < 0.001 |
| In-hospital complication | 3.4 | 3.1 | 5.8 | < 0.001 |
| Discharge destination | ||||
| Home | 81.0 | 82.1 | 71.5 | < 0.001 |
| SNF | 17.3 | 16.3 | 25.8 | |
| Other facility ** | 1.7 | 1.6 | 2.8 | |
| Chemotherapy w/in 30d of discharge | 5.7 | 5.7 | 5.6 | 0.806 |
*
Three SEER registries (Kentucky, Louisiana, and New Jersey) were added in 2000.
**
Other facility includes long-stay, psychiatric, and rehabilitation hospitals.