Patient experience linked to urologic CA surgical outcomes

(HealthDay)—Patient experience is associated with urologic cancer surgical outcomes, according to a study published online June 2 in Cancer.

For the study, Joseph D. Shirk, M.D., from the University of California at Los Angeles, and colleagues used data from the Nationwide Inpatient Sample and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) from 2009 to 2011. Hospital admissions for cancer-directed prostatectomy, nephrectomy, and cystectomy were identified, and mortality, length of hospitalization, discharge disposition, and complications were assessed. The likelihood of selected outcomes was compared between the top and bottom tercile hospitals using mixed effect models.

The researchers observed small differences in patient age, race, income, comorbidity, cancer type, receipt of a minimally invasive surgery, and procedure acuity according to HCAHPS tercile in a sample of 46,988 encounters (P < 0.001). There was variation in hospital characteristics based on ownership, teaching status, size, and location (P < 0.001). Patients treated in high-performing hospitals less frequently faced prolonged hospitalization or nursing-sensitive complications compared with those treated in low-performing hospitals (odds ratios, 0.77 and 0.85, respectively). There was no difference in terms of inpatient mortality, other complications, or discharge disposition (P > 0.05).

"For urologic cancer surgery, patient experience may be optimally viewed as an independent quality domain rather than a mechanism with which to improve surgical outcomes," the authors write.

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