Abstract
Background
Financial toxicity can lead to poor outcomes in surgical oncology patients. This study evaluates the impact of financial toxicity on readmissions in surgical oncology patients, including different-hospital readmissions.
Methods
The Nationwide Readmissions Database was queried for patients admitted with a surgically treated malignancy. Financial toxicity was defined by at least two: lack of insurance, household income in the lowest quartile, or index hospitalization cost in the highest quartile.
Results
Of 108,850 patients, the 30-day readmission rate was 17.4% (n = 18,959), with 19.1% (n = 3,611) readmitted to a different hospital. Financial toxicity was identified in 7.3% (n = 7,888), with a readmission rate of 20.1% (n = 1,585; P < .001). On multivariable regression, the strongest risk factors for readmission were more than 3 comorbidities (OR 1.74 [1.68-1.79]; P < .001), and financial toxicity (OR 1.11 [1.05-1.18]; P < .001).
Conclusion
Surgical oncology patients impacted by financial toxicity are at an increased risk for readmission. Readmission studies from single institutions miss a large portion of these patients with this compounding risk. Outcome improvements can be achieved by reducing financial burdens placed on surgical oncology patients.
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