ArticleMedical care research and review : MCRR2016
Effects of Hospital Type and Distance on Lymph Node Assessment for Colon Cancer Among Metropolitan and Nonmetropolitan Patients in Appalachia.
Article in Medical care research and review : MCRR, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Rural-Urban Disparities in Colorectal Cancer Screening, Diagnosis, Treatment, and Survivorship Care: A Systematic Review and Meta-Analysis.The oncologist · 2024Pooled it
- Barriers to Adherence to Standard of Care in Appalachia: A Qualitative Assessment in Gastrointestinal Cancers.Patient preference and adherence · 2025Article
- Rural Disparities in Hospital Patient Satisfaction: Multilevel Analysis of the Massachusetts AHA, SID, and HCAHPS Data.Journal of patient experience · 2020Article
- Lost in the Black Belt South: health outcomes and transportation infrastructure.Environmental monitoring and assessment · 2019Article
- Use of instrumental variables for endogenous treatment at the provider level.Health economics · 2019Article
- Spatially varying effects of predictors for the survival prediction of nonmetastatic colorectal Cancer.BMC cancer · 2018Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
We studied differences in access to large or accredited cancer programs as a possible explanation for geographic disparities in adherence to the national guideline on lymph node assessment for Stages I to III colon cancer. State cancer registries were linked with Medicare claims of patients diagnosed from 2006 to 2008 from Appalachian counties of four states. Metropolitan and nonmetropolitan patients differed on adherence, proximity to high-volume or accredited hospitals, and hospital type. We modeled effects of hospital type on adherence with ordinary least squares and instrumental variables (instrumenting for hospital type with relative distance). The evidence was strongest for improved adherence in high-volume hospitals for nonmetropolitan patients. We estimate that roughly 100 deaths might be prevented over 5 years among each year's incident cases if the nonmetropolitan disparity in hospital volume were eliminated nationally. We conclude that regionalization or targeting smaller hospitals would improve adherence in nonmetropolitan areas, but also argue for improving adherence generally.
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Registered trials
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