Skilled care utilization after abdominal and pelvic cancer surgery in older patients Journal Article

  


Authors: Alexander, K.; Shahrokni, A.; Mahmoudzadeh Pournaki, S.; Korc-Grodzicki, B.
Article Title: Skilled care utilization after abdominal and pelvic cancer surgery in older patients
Abstract: Background and objectives Older cancer patients are less likely to return home after surgery. Utilization of post acute skilled services in this setting is associated with increased mortality. Medicare payments for post acute care continue to grow. This study aims to identify factors associated with the utilization of post acute services at hospital discharge after abdominopelvic cancer surgery. Methods This is a retrospective analysis of older cancer patients (age > 75) who presented to the Geriatrics clinic at Memorial Sloan Kettering Cancer Center for preoperative evaluation between October 2010 and December 2012. Sociodemographic features, pre-operative geriatric assessment, hospitalization characteristics and discharge disposition data were collected and analyzed. Results Out of 592 patients (age > 75), 291 (49.2%) were discharged home without services and 301 (50.8%) were discharged home with skilled services or to a skilled nursing facility. Older age (OR 1.058, P = 0.010), preoperative ADL dependency (OR 2.242, P = 0.001), longer operation time (OR 1.004, P < 0.001) and postoperative delirium (OR 2.213, P = 0.004) were independently associated with skilled care utilization. Conclusions Optimizing preoperative status, implementing delirium prevention protocols and streamlining the hospital stay may impact the discharge disposition, helping control healthcare costs and achieving a better outcome for the older surgical cancer patient. © 2016 Elsevier Masson SAS and European Union Geriatric Medicine Society
Keywords: cancer surgery; geriatric oncology; skilled care
Journal Title: European Geriatric Medicine
Volume: 7
Issue: 5
ISSN: 1878-7649
Publisher: Springer  
Date Published: 2016-09-01
Start Page: 438
End Page: 442
Language: English
DOI: 10.1016/j.eurger.2016.06.007
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84992200211&partnerID=40&md5=ed20fe0b730ef45e84418174a195bf39
Notes: Article -- Export Date: 2 November 2016 -- Source: Scopus
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MSK Authors
  1. Beatriz Korc-Grodzicki
    129 Korc-Grodzicki
  2. Armin Shahrokni
    133 Shahrokni
  3. Sanam Mahmoud Zadeh Pournaki
    11 Mahmoud Zadeh Pournaki
  4. Koshy Alexander
    53 Alexander
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