title: Skilled nursing facility placement in hospitalized elderly patients with colon cancer.
abstract: BACKGROUND
  The current study sought to determine predictive risk factors and inpatient resource utilization associated with discharge to skilled nursing facility (SNF) in hospitalized elderly patients with colon cancer.
  
  
  METHODS
  Inpatient data from U.S. community hospital discharges from 2003 to 2011 was analyzed in a retrospective cohort study using the Healthcare Cost and Utilization Project, National Inpatient Sample (HCUP-NIS). Subjects included hospitalized postoperative colon cancer patients over age of 65 (N = 98,797).
  
  
  RESULTS
  The proportion of elderly colon cancer patients discharged to a SNF increased by 16.67% from 2003 to 2011 (18-21%). Elderly patients discharged to a SNF had increased hospitalization costs (+$10,293.70, p < 0.01) compared to elderly colon cancer patients discharged home. Hospitalization predictive risk factors associated with SNF placement include age above 75 (OR, 4.07; 95% CI, 3.90, 4.25; p < 0.01), paralysis (OR, 3.60; 95% CI, 3.06-4.23; p < 0.01), length of stay (LOS) 10 days or more (OR, 3.00; 95% CI, 2.88-3.13; p < 0.01), psychoses (OR, 2.91; 95% CI, 2.56-3.32; p < 0.01), and neurological disorders (OR, 2.34; 95% CI, 2.17-2.52; p < 0.01).
  
  
  CONCLUSIONS
  Despite increased costs and worse clinical outcomes associated with SNF placement, over 40% increase of hospital discharge to SNF should be anticipated from this population over the next 20 years. Neurologic and psychiatric comorbidities have significantly negative clinical impacts and increase the likelihood of colon cancer patients' discharge to a SNF.
authors.affiliation: Department of Internal Medicine, 825 Chalkstone Avenue, Roger Williams Medical Center, Providence, RI, 02908, United States; Department of Medicine, 72 East Concord Street, Boston University School of Medicine, Boston, MA, 02118, United States. Electronic address: gcholankeril@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Cholankeril
authors.affiliation: Department of Biostatistics, 121 South Main Street, Brown University School of Public Health, Providence, RI, 02903, United States.
authors.forename: M
authors.initials: M
authors.lastname: Hu
authors.affiliation: Department of Internal Medicine, 825 Chalkstone Avenue, Roger Williams Medical Center, Providence, RI, 02908, United States; Department of Medicine, 72 East Concord Street, Boston University School of Medicine, Boston, MA, 02118, United States.
authors.forename: E
authors.initials: E
authors.lastname: Tanner
authors.affiliation: Department of Internal Medicine, 825 Chalkstone Avenue, Roger Williams Medical Center, Providence, RI, 02908, United States.
authors.forename: R
authors.initials: R
authors.lastname: Cholankeril
authors.affiliation: Department of Surgical Oncology, 825 Chalkstone Avenue, Roger Williams Medical Center, Providence, RI, 02908, United States.
authors.forename: J
authors.initials: J
authors.lastname: Reha
authors.affiliation: Department of Surgical Oncology, 825 Chalkstone Avenue, Roger Williams Medical Center, Providence, RI, 02908, United States.
authors.forename: P
authors.initials: P
authors.lastname: Somasundar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012866:Skilled Nursing Facilities
keywords: Colon cancer; Discharge disposition; Elderly; Skilled nursing home