ArticleJournal of the American College of Surgeons2026
Allocation of Postacute Care Services Differs Among Rural and Urban Patients after Colon Cancer Resection.
Article in Journal of the American College of Surgeons, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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Who cites it
2 citing papers in PubMed.
- Surgical Outcomes and Postacute Care Use Among Rural Medicare Advantage Beneficiaries.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Contextualizing Access to Postacute Care Services Among Rural Surgical Populations: In Reply to Mullens and colleagues.Journal of the American College of Surgeons · 2026Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundCompared with urban, rural patients experience more postoperative complications, including surgical site infections and anastomotic leaks after colon cancer resection. As these complications often require long-term care, we investigated rural-urban differences in postoperative outcomes and discharge disposition. STUDY
designWe identified patients who underwent colon cancer resection from the Surveillance, Epidemiology, and End Results-Medicare database (2014 to 2019). We used multivariable logistic regression models to evaluate rural-urban differences in complications, ICU admission, discharge disposition, readmissions, and postdischarge reoperations. County-level availability of postacute care services (skilled nursing, rehabilitation, home healthcare) was examined using the Area Health Resource File.
resultsAmong 31,635 patients (urban = 82%; rural = 18%), more rural patients were White (88% vs 77%; p < 0.001), underwent open surgery (69% vs 60%; p < 0.001), and had surgery at nonacademic centers (44% vs 64%; p < 0.001). Stage was similar between the groups. Rural patients had lower Charlson Comorbidity Indices (p < 0.001) but more complications (24% vs 22%; p = 0.0039) and ICU admissions (34% vs 30%; p < 0.001). Rural patients had lower odds of being discharged with postacute care services (odds ratio 0.76, 95% CI 0.71 to 0.82); readmissions did not differ, but rural patients underwent more postdischarge reoperations (0.6% vs 0.3%, p = 0.0006). Rural counties had more postacute care facilities (8 [interquartile range [IQR] 5 to 13] vs 4 [IQR 3 to 5], p < 0.001) and home healthcare agencies per 100,000 (3 [IQR 0 to 7] vs 2 [IQR 1 to 5], p < 0.001) compared with urban.
conclusionsRural patients experienced more complications and ICU admissions but had lower odds of being discharged with postacute care services, despite higher per-capita services and facilities available in rural areas. Improving postacute care delivery and usage in rural areas may reduce geographic inequities after colon cancer resection.
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