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Acute clinical and financial outcomes of esophagectomy at safety-net hospitals in the United States

Author

Listed:
  • Sara Sakowitz
  • Russyan Mark Mabeza
  • Syed Shahyan Bakhtiyar
  • Arjun Verma
  • Shayan Ebrahimian
  • Amulya Vadlakonda
  • Sha’shonda Revels
  • Peyman Benharash

Abstract

Background: While safety-net hospitals (SNH) play a critical role in the care of underserved communities, they have been associated with inferior postoperative outcomes. This study evaluated the association of hospital safety-net status with clinical and financial outcomes following esophagectomy. Methods: All adults (≥18 years) undergoing elective esophagectomy for benign and malignant gastroesophageal disease were identified in the 2010–2019 Nationwide Readmissions Database. Centers in the highest quartile for the proportion of uninsured/Medicaid patients were classified as SNH (others: non-SNH). Regression models were developed to evaluate adjusted associations between SNH status and outcomes, including in-hospital mortality, perioperative complications, and resource use. Royston-Parmar flexible parametric models were used to assess time-varying hazard of non-elective readmission over 90 days. Results: Of an estimated 51,649 esophagectomy hospitalizations, 9,024 (17.4%) were performed at SNH. While SNH patients less frequently suffered from gastroesophageal malignancies (73.2 vs 79.6%, p

Suggested Citation

  • Sara Sakowitz & Russyan Mark Mabeza & Syed Shahyan Bakhtiyar & Arjun Verma & Shayan Ebrahimian & Amulya Vadlakonda & Sha’shonda Revels & Peyman Benharash, 2023. "Acute clinical and financial outcomes of esophagectomy at safety-net hospitals in the United States," PLOS ONE, Public Library of Science, vol. 18(5), pages 1-14, May.
    • Handle: RePEc:plo:pone00:0285502
    DOI: 10.1371/journal.pone.0285502
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    References listed on IDEAS

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