Do hospitals that serve a high percentage of medicaid patients perform well on evidence- based guidelines for colon cancer care?

Kim F. Rhoads, Justine V. Ngo, Yifei Ma, Lyen Huang, Mark L. Welton, R. Adams Dudley

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Background. Previous work suggests hospitals serving high percentages of patients with Medicaid are associated with worse colon cancer survival. It is unclear if practice patterns in these settings explain differential outcomes. Hypothesis: High Medicaid hospitals (HMH) have lower compliance with evidence- based care processes (examining 12 or more lymph nodes (LN) during surgical staging and providing appropriate chemotherapy). Methods. Retrospective analysis of stage I-III colon cancers from California Cancer Registry (1996-2006) linked to discharge abstracts and hospital profiles predicted hospital compliance with guidelines and trends in compliance over time. Results. Cases (N=60,000) in 439 hospitals analyzed. High Medicaid hospital settings had lower odds of compliance with the 12 LN exam (ORHMH0.91, CIHMH[0.85, 0.98]) and with the delivery of appropriate chemotherapy (ORHMH0.76, CIHMH[0.67, 0.86]). Conclusions. High Medicaid hospital status is associated with poor performance on evidence- based colon cancer care. Policies to improve the quality of colon cancer care should target these settings.

Original languageEnglish (US)
Pages (from-to)1180-1193
Number of pages14
JournalJournal of health care for the poor and underserved
Volume24
Issue number3
DOIs
StatePublished - Sep 3 2013
Externally publishedYes

Keywords

  • Colon cancer
  • Guideline compliance
  • Guideline compliance colon cancer
  • Medicaid hospitals
  • Quality of care

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