Evidence map›Paper›PMID 39160311›Full record

Observational studySurgical endoscopy2024

Minimally invasive colorectal cancer surgery: an observational study of medicare advantage and fee-for-service beneficiaries.

Emna Bakillah, James Sharpe, Chris Wirtalla, Drew Goldberg, Maria S Altieri, Cary B Aarons, Luke J Keele, Rachel R Kelz

Abstract readObservational Study
In one paragraph

Observational study in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Emna BakillahDepartment of Surgery, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce St, 4 Maloney, Philadelphia, PA, 19104, USA. Emna.Bakillah@pennmedicine.upenn.edu.ORCID 0000-0002-1847-4955
James SharpeDepartment of Surgery, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce St, 4 Maloney, Philadelphia, PA, 19104, USA.
Chris WirtallaDepartment of Surgery, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce St, 4 Maloney, Philadelphia, PA, 19104, USA.
Drew GoldbergDepartment of Surgery, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce St, 4 Maloney, Philadelphia, PA, 19104, USA.
Maria S AltieriDepartment of Surgery, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce St, 4 Maloney, Philadelphia, PA, 19104, USA.
Cary B AaronsDepartment of Surgery, Columbia University, New York, NY, USA.
Luke J KeeleDepartment of Surgery, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce St, 4 Maloney, Philadelphia, PA, 19104, USA.
Rachel R KelzDepartment of Surgery, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce St, 4 Maloney, Philadelphia, PA, 19104, USA.

Funding

Personalized Provider Selection to Reduce Surgical DisparitiesR01MD016088 · NIMHD · UNIVERSITY OF PENNSYLVANIA · PI Rachel Kelz · 2022 to 2026
$3.2M
NIMHD NIH HHS R01 MD016088NIMHD NIH HHS R01MD016088
6 · The paper itself

Abstract

backgroundEnrollment of Medicare beneficiaries in medicare advantage (MA) plans has been steadily increasing. Prior research has shown differences in healthcare access and outcomes based on Medicare enrollment status. This study sought to compare utilization of minimally invasive colorectal cancer (CRC) surgery and postoperative outcomes between MA and Fee-for-Service (FFS) beneficiaries.

methodsA retrospective cohort study of beneficiaries  ≥ 65.5 years of age enrolled in FFS and MA plans was performed of patients undergoing a CRC resection from 2016 to 2019. The primary outcome was operative approach, defined as minimally invasive (laparoscopic) or open. Secondary outcomes included robotic assistance, hospital length-of-stay, mortality, discharge disposition, and hospital readmission. Using balancing weights, we performed a tapered analysis to examine outcomes with adjustment for potential confounders.

resultsMA beneficiaries were less likely to have lymph node (12.9 vs 14.4%, p < 0.001) or distant metastases (15.5% vs 17.0%, p < 0.001), and less likely to receive chemotherapy (6.2% vs 6.7%, p < 0.001), compared to FFS beneficiaries. MA beneficiaries had a higher risk-adjusted likelihood of undergoing laparoscopic CRC resection (OR 1.12 (1.10-1.15), p < 0.001), and similar rates of robotic assistance (OR 1.00 (0.97-1.03), p = 0.912), compared to FFS beneficiaries. There were no differences in risk-adjusted length-of-stay (β coefficient 0.03 (- 0.05-0.10), p = 0.461) or mortality at 30-60-and 90-days (OR 0.99 (0.95-1.04), p = 0.787; OR 1.00 (0.96-1.04), p = 0.815; OR 0.98 (0.95-1.02), p = 0.380). MA beneficiaries had a lower likelihood of non-routine disposition (OR 0.77 (0.75-0.78), p < 0.001) and readmission at 30-60-and 90-days (OR 0.76 (0.73-0.80), p < 0.001; OR 0.78 (0.75-0.81), p < 0.001; OR 0.79 (0.76-0.81), p < 0.001).

conclusionsMA beneficiaries had less advanced disease at the time of CRC resection and a greater likelihood of undergoing a laparoscopic procedure. MA enrollment is associated with improved health outcomes for elderly beneficiaries undergoing operative treatment for CRC.

Indexed as

Colorectal NeoplasmsFee-for-Service PlansMedicare Part CAgedAged, 80 and overColectomyFemaleHumansLaparoscopyLength of StayMaleMinimally Invasive Surgical ProceduresPatient ReadmissionRetrospective StudiesRobotic Surgical ProceduresUnited StatesColorectal cancer surgeryMedicare advantageMedicare fee-for-serviceMinimally invasive surgery

Identifiers

PMID39160311
PMCPMC11525327

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.