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No Difference in Perioperative Outcomes Following Colorectal Cancer Resection Between Flagship and Non-Flagship
Joseph C L'Huillier1,2, Joseph D Boccardo3, Miranda Berkebile1
1Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
Background:
Hospitals are rapidly consolidating to create large healthcare systems. Whether outcomes following colorectal cancer resection at flagship hospitals differ from those at non-flagship hospitals is unknown.
Methods:
A 6-year retrospective analysis of an all-payor New York State (NYS) hospital database was conducted. All adult patients with a colorectal resection for primary resectable colorectal cancer were included. Within each system, the hospital with the most colorectal resections was designated the "flagship" hospital. Thirty-day outcomes at flagship facilities were compared to affiliated, non-flagship hospitals following colorectal resection while matching for patient-level differences.
Results:
In total, 28 400 patients were included across 31 healthcare systems in NYS. There were no differences in mortality (0.9% vs. 1.1%), 30-day readmissions (10.5% vs. 11.9%), or postoperative outcomes between matched patients treated at flagship versus non-flagship facilities (p > 0.05).
Conclusions:
There are no differences in perioperative outcomes between flagship and non-flagship hospitals in a given system in NYS. Patients with resectable non-metastatic colorectal cancer may not need to undergo oncologic resection at flagship hospitals to receive high-quality perioperative care.
