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Geographic Variation in the Utilization of Services Surrounding Lung Cancer Resection.

Darshak S Thosani1, Luke T Meredith1, Richard West2

  • 1Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.

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Summary

Geographic variations in ambulatory care utilization for lung cancer resection patients were significant, while inpatient care showed little difference. These findings suggest geographical factors influence service use in lung cancer treatment pathways.

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Area of Science:

  • Health Services Research
  • Oncology
  • Health Economics

Background:

  • Value-based care models are increasingly emphasized in healthcare.
  • Improved profiling across the continuum of lung cancer care is necessary.
  • Understanding geographic variation in service utilization for lung cancer patients is crucial.

Purpose of the Study:

  • To examine geographic variation in the utilization of services surrounding lung cancer resection.
  • To identify potential geographic drivers influencing healthcare service use in lung cancer care.

Main Methods:

  • Retrospective cohort study of lung cancer resection patients (2017-2019).
  • Utilized hierarchical logistic regression models for risk-adjusted service utilization.
  • Data sourced from inpatient and ambulatory databases across New Jersey, Pennsylvania, Florida, and Maryland.

Main Results:

  • Ambulatory procedure utilization varied significantly across hospital referral regions (HRRs), ranging from 10.9% to 54.9%.
  • Inpatient admissions prior to surgery showed less variation (7.4% to 24.7%).
  • Inpatient hospitalizations post-surgery also demonstrated limited variation (10.0% to 33.6%).

Conclusions:

  • Significant geographic variation exists in ambulatory service utilization for lung cancer resection.
  • Inpatient service utilization surrounding lung cancer resection did not show significant geographic variation.
  • Geographic factors may play a role in the disparities observed in lung cancer care delivery.