Background: Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. Methods: We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed using the 1998 to 2009 Nationwide Inpatient Sample. Logistic regression examined predictors of rurality and the adjusted likelihood of in-hospital mortality at rural and urban hospitals. Results: The fraction of procedures performed at rural hospitals decreased from 12% to 6%. Older age, non-Hispanic white race, and fewer comorbidities predicted rurality. Rural hospitals did not have worse mortality, however, rurality significantly augmented mortality among recipients of complex cancer surgery. Conclusions: Rural hospitals had comparable mortality overall, but delivered poorer outcomes for certain groups. Future research should explore these variations as cancer care is increasingly centralized.
Bibliographical noteFunding Information:
Supported by the 2008 Veterans of Foreign Wars and its Ladies Auxiliary Surgical Oncology Research Award, the Enhancing Minority Participation in Clinical Trials ( EMPaCT ; 5RC2MD004797-02 ) grant, and by the Center for Health Equity, funded by the National Institute for Minority Health Disparities 1P60MD003422 .
- Cancer treatment
- Patterns of care
- Rural health care
- Surgical oncology