Impact of Financial Toxicity in Surgical Oncology Patients on Postoperative Hospital Readmission

BackgroundFinancial toxicity can lead to poor outcomes in surgical oncology patients. This study evaluates the impact of financial toxicity on readmissions in surgical oncology patients, including different-hospital readmissions.MethodsThe Nationwide Readmissions Database was queried for patients admitted with a surgically treated malignancy. Financial toxicity was defined by at least two: lack of insurance, household income in the lowest quartile, or index hospitalization cost in the highest quartile.ResultsOf 108,850 patients, the 30-day readmission rate was 17.4% (n = 18,959), with 19.1% (n = 3,611) readmitted to a different hospital. Financial toxicity was identified in 7.3% (n = 7,888), with a readmission rate of 20.1% (n = 1,585; P < .001). On multivariable regression, the strongest risk factors for readmission were more than 3 comorbidities (OR 1.74 [1.68-1.79]; P < .001), and financial toxicity (OR 1.11 [1.05-1.18]; P < .001).ConclusionSurgical oncology patients impacted by financial toxicity are at an increased risk for readmission. Readmission studies from single institutions miss a large portion of these patients with this compounding risk. Outcome improvements can be achieved by reducing financial burdens placed on surgical oncology patients.