Dataset Information

Recent trends in liver resection surgery activity and population utilization rates in English regions.

ABSTRACT: OBJECTIVE: We conducted a study to examine recent trends in population-based utilization rates for liver resection surgery in England, to help identify potentially unmet healthcare need and to help inform future service planning. MATERIALS AND METHODS: Hospital Episodes Statistics data were analysed for the 5-year period 2000-1 to 2004-5 to identify episodes of care relating to liver resection surgery (defined as OPSC IV codes J21 to J24, J31, J38 and J39). RESULTS: In England, the liver excision surgery population access rate was 1.82 and 2.95/100,000 general population in 2000-1 and 2004-5, respectively--a 62% increase during the 5-year study period, or a mean 12% annual increase. About two-thirds of all liver resection surgery (69%) related to metastatic liver disease. Between English regions, utilization rates ranged from 0.5 to 4.5/100,000 general population in 2000-1; and from 0.8 to 4.6/100 000 general population in 2004-5. DISCUSSION: In recent years, a rapid increase in liver resection surgery activity has been observed. Most of the activity was related to metastatic disease. There was substantial regional variation in population utilization rates within the same country. This variation is unlikely to represent regional differences in disease burden and healthcare need.

SUBMITTER: Lyratzopoulos G

PROVIDER: S-EPMC2215396 | biostudies-other | 2007

REPOSITORIES: biostudies-other

ACCESS DATA

Similar Datasets

Project description:ImportanceAmong patients with colorectal liver metastasis (CRLM) who are eligible for curative-intent liver surgical resection, only half undergo liver metastasectomy. It is currently unclear how rates of liver metastasectomy vary geographically in the US. Geographic differences in county-level socioeconomic characteristics may, in part, explain variability in the receipt of liver metastasectomy for CRLM.ObjectiveTo describe county-level variation in the receipt of liver metastasectomy for CRLM in the US and its association with poverty rates.Design, setting, and participantsThis ecological, cross-sectional, and county-level analysis was conducted using data from the Surveillance, Epidemiology, and End Results Research Plus database. The study included the county-level proportion of patients who had colorectal adenocarcinoma diagnosed between January 1, 2010, and December 31, 2018, underwent primary surgical resection, and had liver metastasis without extrahepatic metastasis. The county-level proportion of patients with stage I colorectal cancer (CRC) was used as a comparator. Data analysis was performed on March 2, 2022.ExposuresCounty-level poverty in 2010 obtained from the US Census (proportion of county population below the federal poverty level).Main outcomes and measuresThe primary outcome was county-level odds of liver metastasectomy for CRLM. The comparator outcome was county-level odds of surgical resection for stage I CRC. Multivariable binomial logistic regression accounting for clustering of outcomes within a county via an overdispersion parameter was used to estimate the county-level odds of receiving a liver metastasectomy for CRLM associated with a 10% increase in poverty rate.ResultsIn the 194 US counties included in this study, there were 11 348 patients. At the county level, the majority of the population was male (mean [SD], 56.9% [10.2%]), White (71.9% [20.0%]), and aged between 50 and 64 (38.1% [11.0%]) or 65 and 79 (33.6% [11.4%]) years. The adjusted odds of undergoing a liver metastasectomy was lower in counties with higher poverty in 2010 (per 10% increase; odds ratio, 0.82 [95% CI, 0.69-0.96]; P = .02). County-level poverty was not associated with receipt of surgery for stage I CRC. Despite the difference in rates of surgery (mean county-level rates were 0.24 for liver metastasectomy for CRLM and 0.75 for surgery for stage I CRC), the variance at the county-level for these 2 surgical procedures was similar (F370, 193 = 0.81; P = .08).Conclusions and relevanceThe findings of this study suggest that higher poverty was associated with lower receipt of liver metastasectomy among US patients with CRLM. Surgery for a more common and less complex cancer comparator (ie, stage I CRC) was not observed to be associated with county-level poverty rates. However, county-level variation in surgical rates was similar for CRLM and stage I CRC. These findings further suggest that access to surgical care for complex gastrointestinal cancers such as CRLM may be partially influenced by where patients live.

Dataset Information

Recent trends in liver resection surgery activity and population utilization rates in English regions.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets