Highlights
- •Higher facility volume is associated with improved rectal cancer resection outcomes.
- •However, older patients are less likely to be treated at high-volume facilities.
- •This may be partly because older patients tend to travel shorter distances for care.
Abstract
Background
The association between volume and outcomes has led to recommendations that patients
undergo surgery at high-volume centers. We aimed to determine if older patients with
rectal cancer are undergoing operations at high-volume centers.
Methods
We identified patients ≥50 years old who underwent rectal cancer resection using the
NCDB (2004–2015). Tertiles were used to categorize facility volume and distance traveled.
Results
Higher facility volume was associated with improved outcomes. Patients >75 years old
were less likely than patients 50–59 years old to be treated at high-volume centers. Traveling
>16.8 miles was associated with treatment at high-volume facilities, however patients
>75 years old were less likely to travel >16.8 miles.
Conclusions
Higher facility volume is associated with improved outcomes after rectal cancer resection.
However, older patients are less likely to be treated at high-volume facilities. Older
patients travel shorter distances for care, suggesting that care integration across
networks must be optimized.
Keywords
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Article info
Publication history
Published online: September 23, 2021
Accepted:
September 20,
2021
Received in revised form:
September 12,
2021
Received:
July 26,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
