Trends in Discharge Disposition Following Hepatectomy for Hepatocellular Carcinoma Among Medicare Beneficiaries

Post-acute care (PAC) services can include home healthcare, long-term hospitals, and skilled nursing facilities. We sought to define factors associated with PAC discharge disposition among Medicare beneficiaries who underwent hepatectomy for hepatocellular carcinoma (HCC). Data a diagnosis of HCC between 2004 2015 were retrieved from the SEER-Medicare database. Discharge was defined as routine (HSC: discharged home) or non-routine (SNF/ICF, nursing/intermediate facilities, HHA, health agency). The Cochran-Mantel-Haenszel test multivariable logistic regression used assess trends in disposition. Among 1305 patients, median patient age at 72 years (IQR: 68–76). Approximately 4 5 patients HSC (77.4%; n = 1010). odds decreased by 7.0% annually (ORtrend, 0.93; 95%CI, 0.89–0.97; ptrend 0.001). Several discharge, including (OR 1.06, 95%CI 1.04–1.09) longer LOS 1.07, 1.05–1.10). In contrast, had minor 0.69, 0.52–0.93) teaching hospital 0.63, 0.45–0.89) lower (all P < 0.05). increased over time (2004–2007 (n 205, 68.1%) vs. 2008–2011 330, 77.8%) 2012–2015 475, 81.9%); Over same period, there decreasing trend 90-day readmission 91, 30.2%) 107, 25.2%) 129, 22.2%); 0.03). Utilization following hepatic resection 57.0% 2015. These data highlight that utilization not generally higher rates HCC.