Travel Distance to Provider Predicts Post-Cystectomy Readmission

A travel distance of more than 30 miles to the provider was associated with greater chances of readmission in one analysis.
A travel distance of more than 30 miles to the provider was associated with greater chances of readmission in one analysis.

Hospital readmission rates within the first month of cystectomy are higher among bladder cancer patients who travel greater distances to the provider, according to a new study presented at the 2016 Genitourinary Cancers Symposium in San Francisco.

Patients who experience complications within 30 days of cystectomy may benefit from closer follow-up, suggests a research team led by Troy Sukhu, MD, of the University of North Carolina at Chapel Hill. Readmission rates typically range from 25%-43%, and hospital and patient factors possibly influence rates. The investigators hypothesized that greater distance between patient and provider would increase the risk of readmission following surgery. 

Dr. Sukhu's team examined complication rates following radical cystectomy using the NC Central Cancer Registry and administrative claims data from 2003–2008. Travel distances were calculated using the zip codes of the patient and cystectomy provider.

Of 735 total cystectomy patients, 171 (23%) were readmitted within 30 days and 156 (21%) within 31–90 days. The investigators observed no significant differences in complication rates based on age, race, bladder cancer stage, co-existing conditions, or complication type (e.g., genitourinary, gastrointestinal, wound, infection, venous thromboembolism, etc.)

A bivariable analysis revealed that a travel distance of more than 30 miles to the provider was associated with greater chances of readmission. On multivariable analysis, the only predictor of 30-day readmission was a longer travel distance. No significant predictors were identified for 31–90 day readmissions.

Source

  1. Sukhu  T, Lomboy J, Macey M, et al. The Relationship Between Travel Distance to Cystectomy and Likelihood of Readmission. J Clin Oncol 34, 2016 [suppl 2S; abstr 462].

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