The Value of Continuity between Primary Care and Surgical Care in Colon Cancer

Tanvir Hussain, Hsien Yen Chang, Ngoc Phuong Luu, Craig Evan Pollack

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Improving continuity between primary care and cancer care is critical for improving cancer outcomes and curbing cancer costs. A dimension of continuity, we investigated how regularly patients receive their primary care and surgical care for colon cancer from the same hospital and whether this affects mortality and costs. Methods Using Surveillance, Epidemiology, and End Results Program Registry (SEER)-Medicare data, we performed a retrospective cohort study of stage I-III colon cancer patients diagnosed between 2000 and 2009. There were 23,305 stage I-III colon cancer patients who received primary care in the year prior to diagnosis and underwent operative care for colon cancer. Patients were assigned to the hospital where they had their surgery and to their primary care provider's main hospital, and then classified according to whether these two hospitals were same or different. Outcomes examined were hazards for all-cause mortality, subhazard for colon cancer specific mortality, and generalized linear estimate for costs at 12 months, from propensity score matched models. Results Fifty-two percent of stage I-III colon patients received primary care and surgical care from the same hospital. Primary care and surgical care from the same hospital was not associated with reduced all-cause or colon cancer specific mortality, but was associated with lower inpatient, outpatient, and total costs of care. Total cost difference was $8,836 (95% CI $2,746-$14,577), a 20% reduction in total median cost of care at 12 months. Conclusions Receiving primary care and surgical care at the same hospital, compared to different hospitals, was associated with lower costs but still similar survival among stage I-III colon cancer patients. Nonetheless, health care policy which encourages further integration between primary care and cancer care in order to improve outcomes and decrease costs will need to address the significant proportion of patients receiving health care across more than one hospital.

Original languageEnglish (US)
Article numbere0155789
JournalPloS one
Volume11
Issue number5
DOIs
StatePublished - May 2016

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colorectal neoplasms
Colonic Neoplasms
Primary Health Care
Costs and Cost Analysis
Costs
Mortality
neoplasms
Health care
Neoplasms
health services
SEER Program
Delivery of Health Care
Cancer Care Facilities
Propensity Score
Epidemiology
Critical Care
Medicare
Health Policy
cohort studies
Registries

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

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Hussain, T., Chang, H. Y., Luu, N. P., & Pollack, C. E. (2016). The Value of Continuity between Primary Care and Surgical Care in Colon Cancer. PloS one, 11(5), [e0155789]. https://doi.org/10.1371/journal.pone.0155789

The Value of Continuity between Primary Care and Surgical Care in Colon Cancer. / Hussain, Tanvir; Chang, Hsien Yen; Luu, Ngoc Phuong; Pollack, Craig Evan.

In: PloS one, Vol. 11, No. 5, e0155789, 05.2016.

Research output: Contribution to journalArticle

Hussain, Tanvir ; Chang, Hsien Yen ; Luu, Ngoc Phuong ; Pollack, Craig Evan. / The Value of Continuity between Primary Care and Surgical Care in Colon Cancer. In: PloS one. 2016 ; Vol. 11, No. 5.
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