Table 1. Characteristics colon cancer patients, by receipt of same versus different hospital primary care and surgical care.
| Same Hospital Care Delivery | Different Hospital Care Delivery | p-value | Odds Ratio (95%CI) for Same Hospital Care Delivery* | |
|---|---|---|---|---|
| n = 12,156 (52.2%) | n = 11,149 (47.8%) | |||
| PATIENT-LEVEL CHARACTERISTICS | ||||
| Age | <0.001 | |||
| >65–70 | 1610 (13.2) | 1512 (13.6) | Ref | |
| 71–75 | 2434 (20.0) | 2479 (22.2) | 0.96 (0.90–1.01) | |
| 76–80 | 2978 (24.5) | 2741 (24.6) | 0.99 (0.91–1.10) | |
| 81–85 | 2797 (23.0) | 2446 (21.9) | 1.06 (0.96–1.17) | |
| >86 | 2337 (19.2) | 1971 (17.7) | 1.05 (0.97–1.16) | |
| Female | 7179 (59.1) | 6513 (58.4) | 0.32 | 0.99 (0.94–1.05) |
| Race | <0.001 | |||
| White | 10828 (89.1) | 9557 (85.7) | Ref | |
| Black | 716 (5.9) | 800 (7.2) | 0.96 (0.78–1.19) | |
| Other | 712 (5.0) | 792 (7.1) | 1.08 (0.80–1.57) | |
| Census Tract Median Income | 0.01 | |||
| Lowest Quartile | 2964 (24.4) | 2853 (25.6) | Ref | |
| 2nd Quartile | 3069 (25.3) | 2764 (24.8) | 1.03 (0.88–1.21) | |
| 3rd Quartile | 3131 (25.8) | 2696 (24.2) | 1.05 (0.87–1.27) | |
| Highest Quartile | 2992 (24.6) | 2836 (25.2) | 1.02 (0.80–1.32) | |
| Urban/Rural Residence | <0.001 | |||
| ≥1 million population | 6168 (50.7) | 6479 (58.1) | Ref | |
| ≥250000 to < 1 mil | 3992 (32.3) | 3006 (27.0) | 1.12 (0.80–1.56) | |
| <250,000 | 2066 (17.0) | 1664 (14.9) | 1.02 (0.71–1.49) | |
| Charlson Comorbidity Score | 0.11 | |||
| 0 | 6755 (55.6) | 6042 (54.2) | Ref | |
| 1 | 3092 (25.4) | 2921 (26.2) | 0.95 (0.89–1.01) | |
| ≥2 | 2309 (19.0) | 2186 (19.6) | 0.97 (0.90–1.06) | |
| Stage | 0.008 | |||
| I | 1447 (11.9) | 1185 (10.6) | Ref | |
| II | 8353 (68.7) | 7798 (69.9) | 0.89 (0.77–1.03) | |
| III | 2357 (19.4) | 2167 (19.4) | 0.91 (0.76–1.08) | |
| Substage† | ||||
| Stage II | 0.98 | N/A‡ | ||
| IIa | 2334 (89.0) | 2332 (89.0) | ||
| IIb | 289 (11.0) | 287 (11.0) | ||
| Stage III | 0.71 | N/A‡ | ||
| IIIa | 239 (11.2) | 240 (11.1) | ||
| IIIb | 1226 (57.8) | 1226 (56.7) | ||
| IIIc | 658 (31.0) | 695 (32.2) | ||
| Tumor Grade | 0.008 | |||
| Well Differentiated | 1280 (10.5) | 1025 (9.2) | Ref | |
| Moderately | 8353 (68.7) | 7798 (69.9) | 0.89 (0.77–1.03) | |
| Poorly | 2356 (19.4) | 2166 (19.4) | 0.91 (0.76–1.08) | |
| Undifferentiated | 167 (1.3) | 160 (1.4) | 0.79 (0.59–1.06) | |
| Adequate lymph node resection | 0.27 | |||
| <12 | 4623 (38.0) | 4162 (37.3) | Ref | |
| ≥12 | 7533 (62.0) | 6987 (62.7) | 1.02 (0.93–1.13) | |
| PROVIDER-LEVEL CHARACTERISTICS | ||||
| Yearly surgical volume | <0.001 | |||
| Lowest Quartile | 2187 (18.0) | 2637 (23.7) | Ref | |
| 2nd Quartile | 2381 (19.6) | 2169 (19.5) | 1.32 (1.20–1.47) | |
| 3rd Quartile | 3818 (31.4) | 3068 (27.5) | 1.43 (1.30–1.59) | |
| Highest Quartile | 3770 (31.0) | 3275 (29.4) | 1.52 (1.35–1.61) | |
| HOSPITAL-LEVEL CHARACTERISTICS | ||||
| Surgical Hospital§ Volume | <0.001 | |||
| Lowest Quartile | 2554 (21.1) | 3204 (29.0) | Ref | |
| 2nd Quartile | 3215 (26.5) | 2541 (23.0) | 1.19 (0.89–1.75) | |
| 3rd Quartile | 3163 (26.1) | 2759 (24.9) | 1.17 (0.83–1.64) | |
| Highest Quartile | 3181 (26.3) | 2561 (23.1) | 1.25 (0.83–1.88) | |
| NCI Cancer Center | ||||
| Surgical Hospital§ | 200 (1.7) | 516 (4.6) | <0.001 | 0.30 (0.15–0.60)¶ |
| Academic Center | ||||
| Surgical Hospital§ | 6551 (53.9) | 5831 (52.3) | 0.02 | 0.83 (0.65–1.06)# |
| PCP Hospital‖ | 6551 (53.9) | 6123 (54.9) | 0.15 | 0.92 (0.92–1.13)# |
| For Profit Hospital | ||||
| Surgical Hospital§ | 813 (6.7) | 1160 (10.4) | <0.001 | 0.83 (0.61–1.12)** |
| PCP Hospital‖ | 813 (6.7) | 1027 (9.2) | <0.001 | 1.06 (0.78–1.43)** |
| OUTCOME MEASURES | ||||
| Number of Deaths | 6150 (50.6) | 5238 (47.0) | 0.041 | N/A |
| Median total cost for first year of care (IQR) | $44,722 ($30,432-$75,219) | $50,707 ($22,930-$81,653) | <0.001 | N/A |
*: Odds Ratios are fully adjusted for all other variables listed here (except substage as this is not available until 2004), as well as diagnosis year and SEER site which are not shown
†: Sample restricted to those diagnosed between 2004 onward, for whom this data are available
‡: Not included in model because substage data is available only for all patients, only after 2004
§: The hospital where the patient had surgery
‖: The hospital with which the patient’s PCP is primarily affiliated
¶: Reference group includes hospitals not designated as NCI centers
#: Reference group includes non-academic hospitals.
**: Reference group includes non-profit hospitals.