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Association Between Utilization of Services and Perioperative Outcomes for Lung Cancer Resection.
Thosani, Darshak S; Meredith, Luke T; West, Richard; Till, Brian M; Rahman, Uzma; Mack, Shale J; Koeneman, Scott; Okusanya, Olugbenga T; Evans, Nathaniel R; Grenda, Tyler R.
Afiliación
  • Thosani DS; Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
  • Meredith LT; Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA. Electronic address: lxm460@jefferson.edu.
  • West R; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
  • Till BM; Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
  • Rahman U; Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
  • Mack SJ; Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA.
  • Koeneman S; Division of Biostatistics and Bioinformatics, Physiology and Cancer Biology, Department of Pharmacology, Sidney Kimmel Medical College, Philadelphia, PA.
  • Okusanya OT; Division of Thoracic and Esophageal Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
  • Evans NR; Division of Thoracic and Esophageal Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
  • Grenda TR; Division of Thoracic and Esophageal Surgery, Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
Clin Lung Cancer ; 2024 May 20.
Article en En | MEDLINE | ID: mdl-38879395
ABSTRACT

INTRODUCTION:

Lung cancer resection has largely focused on perioperative outcomes (eg, mortality) to benchmark performance. While variations in perioperative outcomes and in utilization of services (eg, ambulatory procedures, hospitalization) have been independently demonstrated, there has been limited evaluation of associations between these outcomes. We evaluated the association between perioperative outcomes and utilization of services to evaluate provider performance across a broader context of care. PATIENTS AND

METHODS:

This was a retrospective cohort study of patients undergoing lung cancer resection in 2017 to 2019. We utilized hierarchical logistic regression models to determine risk- and reliability-adjusted mortality and risk-adjusted utilization of services, at the hospital-level. We then evaluated utilization of services across quartiles of perioperative mortality.

RESULTS:

A total of 15,168 patients across 297 hospitals underwent lung cancer resection. Mean risk- and reliability-adjusted 90-day mortality varied between 1.58% (95% CI, 1.54%-1.62%) and 2.74% (95% CI, 2.59%-2.90%) across quartiles. Risk-adjusted utilization of all ambulatory procedures was highest in the best performing (lowest mortality) quartile at 37.7% (95% CI, 33.6%-41.8%). Additionally, risk-adjusted inpatient utilization prior to and after surgery was lowest in the best performing quartile at 15% (95% CI, 13.7%-16.3%) and 19.3% (95% CI, 17.5%-21.0%), respectively.

CONCLUSIONS:

Hospitals with the lowest perioperative mortality demonstrated trends towards using more outpatient resources prior to surgery, but fewer inpatient services surrounding lung cancer resection. This correlation highlights the importance of incorporating utilization of services in addition to other metrics to profile the efficiency and effectiveness of centers performing lung cancer resection across a broader spectrum of care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Lung Cancer Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Panamá Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Clin Lung Cancer Asunto de la revista: NEOPLASIAS Año: 2024 Tipo del documento: Article País de afiliación: Panamá Pais de publicación: Estados Unidos