Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 2;14(3):292-297.
doi: 10.17161/kjm.vol14.15597. eCollection 2021.

Rural-Urban Differences in Esophagectomy for Cancer

Joseph G Brungardt  1 , Omar A Almoghrabi  2 , Carolyn B Moore  2 , G John Chen  1 , Alykhan S Nagji  2
Affiliations

Rural-Urban Differences in Esophagectomy for Cancer

Joseph G Brungardt et al. Kans J Med. .

Abstract

Introduction: Patients who are disadvantaged socioeconomically or live in rural areas may not pursue surgery at high-volume centers where outcomes are better for some complex procedures. The objective of this study was to compare rural and urban patient differences directly by location of residence and outcomes after undergoing esophagectomy for cancer.

Methods: An analysis of the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) database was performed, capturing adult patients with esophageal cancer who underwent esophagectomy. Patients were stratified into rural or urban groups by the National Center for Health Statistics Urban-Rural Classification Scheme. Demographics, hospital variables, and outcomes were compared.

Results: A total of 2,877 patients undergoing esophagectomy for esophageal cancer were captured by the database, with 228 (7.92%) rural and 2,575 (89.50%) urban patients. The rural and urban groups had no differences in age, race, and insurance status, and shared many common comorbidities. Major outcomes of mortality (3.95% versus 4.27%, p = 0.815) and length of stay (15.75 ± 13.22 vs. 15.55 ± 14.91 days, p = 0.828) were similar for both rural and urban patients. There was a trend for rural patients to more likely be discharged home (35.96% vs. 29.79%, OR 0.667 [95% CI 0.479 - 0.929]; p = 0.0167).

Conclusions: This retrospective administrative database study indicated that rural and urban patients received equivalent postoperative care after undergoing esophagectomy. The findings were reassuring as there did not appear to be a disparity in major outcomes depending on the location of residence, but further studies are necessary to assure equitable treatment for rural patients.

Keywords: esophageal cancer; geography; health care disparities; rural health services; urban health.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patient selection was from the Healthcare Cost and Utilization Project database and included all patients coded within the database, those diagnosed with esophageal cancer, and those who underwent esophagectomy for cancer. Only patients who underwent esophagectomy were studied.
See this image and copyright information in PMC

References

    1. Chaudhary MA, Shah AA, Zogg CK, et al. Differences in rural and urban outcomes: A national inspection of emergency general surgery patients. J Surg Res. 2017;218:277–284. - PubMed
    1. Ross KH, Patzer RE, Goldberg D, Osborne NH, Lynch RJ. Rural-urban differences in in-hospital mortality among admissions for end-stage liver disease in the United States. Liver Transpl. 2019;25(9):1321–1332. - PubMed
    1. Thomas AA, Pearce A, O’Neill C, Molcho M, Sharp L. Urban-rural differences in cancer-directed surgery and survival of patients with non-small cell lung cancer. J Epidemiol Community Health. 2017;71(5):468–474. - PubMed
    1. Poulose BK, Phillips S, Nealon W, et al. Choledocholithiasis management in rural America: Health disparity or health opportunity? J Surg Res. 2011;170(2):214–219. - PubMed
    1. Shelton J, Kummerow K, Phillips S, et al. An urban-rural blight? Choledocholithiasis presentation and treatment. J Surg Res. 2012;173(2):193–197. - PubMed

LinkOut - more resources