Receipt of appropriate surgical care for medicare beneficiaries with cancer

Caprice C. Greenberg, Stuart R. Lipsitz, Bridget Neville, Haejin In, Nathanael Hevelone, Stacy A. Porter, Christine Weeks, Ashish K. Jha, Atul A. Gawande, Deborah Schrag, Jane C. Weeks

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Objective: To investigate receipt of appropriate surgical care in Medicare beneficiaries with cancer. Design: Retrospective cohort study. Setting: National Surveillance, Epidemiology, and End Results registry linked to Medicare claims data. Patients: Fee-for-service Medicare patients aged 65 years or older who underwent a definitive surgical resection for breast, colon, gastric, rectal, or thyroid cancer diagnosed between January 2000 and December 2005. Claims data were available from January 1999 through December 2007. Main Outcome Measures: Receipt of care concordant with established practice guidelines in surgical oncology in the aggregate and by hospital. Results: Concordance with guidelines was greater than 90% for 7 of 11 measures. All guidelines regarding adjuvanttherapy had concordance rates greater than 90%. Only 2 of 5 measures for nodal management had concordance rates greater than 90%. At least 50% of hospitals provided guideline-concordant care to 100% of their patients for 6 of 11 guidelines. Patients receiving appropriate care tended to be younger, healthier, white, and more affluent, to have less advanced disease, and to live in the Midwest. Conclusions:Wefound a high level of concordance with guidelines in some domains of surgical oncology care but far less so in others, particularly for gastric and colon nodal management. Given the current national focus on improving the quality of health care, surgeons must focus on generating data to define appropriate care and translating those data into everyday practice.

Original languageEnglish (US)
Pages (from-to)1128-1134
Number of pages7
JournalArchives of Surgery
Volume146
Issue number10
DOIs
StatePublished - Oct 2011
Externally publishedYes

Fingerprint

Medicare
Guidelines
Neoplasms
Colon
Fee-for-Service Plans
Quality of Health Care
Rectal Neoplasms
Thyroid Neoplasms
Practice Guidelines
Stomach Neoplasms
Registries
Stomach
Epidemiology
Breast
Cohort Studies
Retrospective Studies
Outcome Assessment (Health Care)
Surgical Oncology

ASJC Scopus subject areas

  • Surgery

Cite this

Greenberg, C. C., Lipsitz, S. R., Neville, B., In, H., Hevelone, N., Porter, S. A., ... Weeks, J. C. (2011). Receipt of appropriate surgical care for medicare beneficiaries with cancer. Archives of Surgery, 146(10), 1128-1134. https://doi.org/10.1001/archsurg.2011.141

Receipt of appropriate surgical care for medicare beneficiaries with cancer. / Greenberg, Caprice C.; Lipsitz, Stuart R.; Neville, Bridget; In, Haejin; Hevelone, Nathanael; Porter, Stacy A.; Weeks, Christine; Jha, Ashish K.; Gawande, Atul A.; Schrag, Deborah; Weeks, Jane C.

In: Archives of Surgery, Vol. 146, No. 10, 10.2011, p. 1128-1134.

Research output: Contribution to journalArticle

Greenberg, CC, Lipsitz, SR, Neville, B, In, H, Hevelone, N, Porter, SA, Weeks, C, Jha, AK, Gawande, AA, Schrag, D & Weeks, JC 2011, 'Receipt of appropriate surgical care for medicare beneficiaries with cancer', Archives of Surgery, vol. 146, no. 10, pp. 1128-1134. https://doi.org/10.1001/archsurg.2011.141
Greenberg CC, Lipsitz SR, Neville B, In H, Hevelone N, Porter SA et al. Receipt of appropriate surgical care for medicare beneficiaries with cancer. Archives of Surgery. 2011 Oct;146(10):1128-1134. https://doi.org/10.1001/archsurg.2011.141
Greenberg, Caprice C. ; Lipsitz, Stuart R. ; Neville, Bridget ; In, Haejin ; Hevelone, Nathanael ; Porter, Stacy A. ; Weeks, Christine ; Jha, Ashish K. ; Gawande, Atul A. ; Schrag, Deborah ; Weeks, Jane C. / Receipt of appropriate surgical care for medicare beneficiaries with cancer. In: Archives of Surgery. 2011 ; Vol. 146, No. 10. pp. 1128-1134.
@article{914e1400454547938c8b8c8968471db0,
title = "Receipt of appropriate surgical care for medicare beneficiaries with cancer",
abstract = "Objective: To investigate receipt of appropriate surgical care in Medicare beneficiaries with cancer. Design: Retrospective cohort study. Setting: National Surveillance, Epidemiology, and End Results registry linked to Medicare claims data. Patients: Fee-for-service Medicare patients aged 65 years or older who underwent a definitive surgical resection for breast, colon, gastric, rectal, or thyroid cancer diagnosed between January 2000 and December 2005. Claims data were available from January 1999 through December 2007. Main Outcome Measures: Receipt of care concordant with established practice guidelines in surgical oncology in the aggregate and by hospital. Results: Concordance with guidelines was greater than 90{\%} for 7 of 11 measures. All guidelines regarding adjuvanttherapy had concordance rates greater than 90{\%}. Only 2 of 5 measures for nodal management had concordance rates greater than 90{\%}. At least 50{\%} of hospitals provided guideline-concordant care to 100{\%} of their patients for 6 of 11 guidelines. Patients receiving appropriate care tended to be younger, healthier, white, and more affluent, to have less advanced disease, and to live in the Midwest. Conclusions:Wefound a high level of concordance with guidelines in some domains of surgical oncology care but far less so in others, particularly for gastric and colon nodal management. Given the current national focus on improving the quality of health care, surgeons must focus on generating data to define appropriate care and translating those data into everyday practice.",
author = "Greenberg, {Caprice C.} and Lipsitz, {Stuart R.} and Bridget Neville and Haejin In and Nathanael Hevelone and Porter, {Stacy A.} and Christine Weeks and Jha, {Ashish K.} and Gawande, {Atul A.} and Deborah Schrag and Weeks, {Jane C.}",
year = "2011",
month = "10",
doi = "10.1001/archsurg.2011.141",
language = "English (US)",
volume = "146",
pages = "1128--1134",
journal = "JAMA Surgery",
issn = "2168-6254",
publisher = "American Medical Association",
number = "10",

}

TY - JOUR

T1 - Receipt of appropriate surgical care for medicare beneficiaries with cancer

AU - Greenberg, Caprice C.

AU - Lipsitz, Stuart R.

AU - Neville, Bridget

AU - In, Haejin

AU - Hevelone, Nathanael

AU - Porter, Stacy A.

AU - Weeks, Christine

AU - Jha, Ashish K.

AU - Gawande, Atul A.

AU - Schrag, Deborah

AU - Weeks, Jane C.

PY - 2011/10

Y1 - 2011/10

N2 - Objective: To investigate receipt of appropriate surgical care in Medicare beneficiaries with cancer. Design: Retrospective cohort study. Setting: National Surveillance, Epidemiology, and End Results registry linked to Medicare claims data. Patients: Fee-for-service Medicare patients aged 65 years or older who underwent a definitive surgical resection for breast, colon, gastric, rectal, or thyroid cancer diagnosed between January 2000 and December 2005. Claims data were available from January 1999 through December 2007. Main Outcome Measures: Receipt of care concordant with established practice guidelines in surgical oncology in the aggregate and by hospital. Results: Concordance with guidelines was greater than 90% for 7 of 11 measures. All guidelines regarding adjuvanttherapy had concordance rates greater than 90%. Only 2 of 5 measures for nodal management had concordance rates greater than 90%. At least 50% of hospitals provided guideline-concordant care to 100% of their patients for 6 of 11 guidelines. Patients receiving appropriate care tended to be younger, healthier, white, and more affluent, to have less advanced disease, and to live in the Midwest. Conclusions:Wefound a high level of concordance with guidelines in some domains of surgical oncology care but far less so in others, particularly for gastric and colon nodal management. Given the current national focus on improving the quality of health care, surgeons must focus on generating data to define appropriate care and translating those data into everyday practice.

AB - Objective: To investigate receipt of appropriate surgical care in Medicare beneficiaries with cancer. Design: Retrospective cohort study. Setting: National Surveillance, Epidemiology, and End Results registry linked to Medicare claims data. Patients: Fee-for-service Medicare patients aged 65 years or older who underwent a definitive surgical resection for breast, colon, gastric, rectal, or thyroid cancer diagnosed between January 2000 and December 2005. Claims data were available from January 1999 through December 2007. Main Outcome Measures: Receipt of care concordant with established practice guidelines in surgical oncology in the aggregate and by hospital. Results: Concordance with guidelines was greater than 90% for 7 of 11 measures. All guidelines regarding adjuvanttherapy had concordance rates greater than 90%. Only 2 of 5 measures for nodal management had concordance rates greater than 90%. At least 50% of hospitals provided guideline-concordant care to 100% of their patients for 6 of 11 guidelines. Patients receiving appropriate care tended to be younger, healthier, white, and more affluent, to have less advanced disease, and to live in the Midwest. Conclusions:Wefound a high level of concordance with guidelines in some domains of surgical oncology care but far less so in others, particularly for gastric and colon nodal management. Given the current national focus on improving the quality of health care, surgeons must focus on generating data to define appropriate care and translating those data into everyday practice.

UR - http://www.scopus.com/inward/record.url?scp=80054766769&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054766769&partnerID=8YFLogxK

U2 - 10.1001/archsurg.2011.141

DO - 10.1001/archsurg.2011.141

M3 - Article

VL - 146

SP - 1128

EP - 1134

JO - JAMA Surgery

JF - JAMA Surgery

SN - 2168-6254

IS - 10

ER -