Document Detail


Does travel distance influence length of stay in elective colorectal surgery?
MedLine Citation:
PMID:  23392153     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: : Length of stay following elective colorectal surgery is being reported as a quality measure in surgical outcome registries, such as the National Surgical Quality Improvement Program. Regional referral centers with large geographic catchment areas attract patients from significant distances.
OBJECTIVE: : The aim of this study was to examine the effect of patient distance traveled, from primary residence to a tertiary care hospital, on length of stay in elective colorectal surgery patients.
DESIGN: : Retrospective population-based cohort study uses data obtained from the National Surgical Quality Improvement Program database.
SETTINGS: : This study was conducted at a tertiary referral hospital.
PATIENTS: : Data on 866 patients undergoing elective colorectal surgery from May 2003 to April 2011 were reviewed.
MAIN OUTCOME MEASURES: : Demographics, surgery-related variables, and distance traveled were analyzed relative to the length of stay.
RESULTS: : Of the 866 patients, 54% were men, mean age was 57 years, mean distance traveled was 145 miles (range, 2-2984 miles), and mean length of stay was 8.8 days. Univariate analysis showed a significant increase in length of stay with increased distance traveled (p = 0.02). Linear regression analysis revealed a significant association between increased length of stay and male sex (p = 0.006), increasing ASA score (p = 0.000), living alone (p = 0.009), and increased distance traveled (p = 0.028). For each incremental increase in log distance traveled, the length of stay increases by 2.5%.
LIMITATIONS: : This is a retrospective review that uses National Surgical Quality Improvement Program data. It is not known how many patients left the hospital and did not return to their primary residence.
CONCLUSIONS: : In a model that controlled for variables, increased travel distance from a patient's residence to the surgical hospital was associated with an increase in length of stay. If length of stay is a reportable quality measure in patients undergoing colorectal surgery, significant travel distance should be accounted for in the risk adjustment model calculations.
Authors:
Katharine L Jackson; Robert E Glasgow; Britani R Hill; Mary C Mone; Bradford Sklow; Courtney L Scaife; Xiaoming Sheng; William J Peche
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  56     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  367-73     Citation Subset:  IM    
Affiliation:
1 Department of Surgery, University of Utah, Salt Lake City, Utah 2 Department of Pediatrics, University of Utah, Salt Lake City, Utah.
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