{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T01:17:46Z","timestamp":1781918266801,"version":"3.54.5"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,3]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Compared 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\u2013urban differences in postoperative outcomes and discharge disposition.<\/jats:p>\n <\/jats:sec>\n \n STUDY DESIGN:<\/jats:title>\n We identified patients who underwent colon cancer resection from the Surveillance, Epidemiology, and End Results\u2013Medicare database (2014 to 2019). We used multivariable logistic regression models to evaluate rural\u2013urban 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.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n Among 31,635 patients (urban\u2009=\u200982%; rural\u2009=\u200918%), more rural patients were White (88% vs 77%; p\u2009<\u20090.001), underwent open surgery (69% vs 60%; p\u2009<\u20090.001), and had surgery at nonacademic centers (44% vs 64%; p\u2009<\u20090.001). Stage was similar between the groups. Rural patients had lower Charlson Comorbidity Indices (p\u2009<\u20090.001) but more complications (24% vs 22%; p\u2009=\u20090.0039) and ICU admissions (34% vs 30%; p\u2009<\u20090.001). 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\u2009=\u20090.0006). Rural counties had more postacute care facilities (8 [interquartile range [IQR] 5 to 13] vs 4 [IQR 3 to 5], p\u2009<\u20090.001) and home healthcare agencies per 100,000 (3 [IQR 0 to 7] vs 2 [IQR 1 to 5], p\u2009<\u20090.001) compared with urban.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Rural 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/xcs.0000000000001663","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T13:00:17Z","timestamp":1763384417000},"page":"527-536","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Allocation of Postacute Care Services Differs Among Rural and Urban Patients after Colon Cancer Resection"],"prefix":"10.1097","volume":"242","author":[{"given":"Sara","family":"Myers","sequence":"first","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Chan, Murillo, Ng, Beresneva, Rivard, Sachs, Davids)"},{"name":"Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (Myers, Chan, Beresneva, Rivard, Sachs, Davids)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang Pong","family":"Chan","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Chan, Murillo, Ng, Beresneva, Rivard, Sachs, Davids)"},{"name":"Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (Myers, Chan, Beresneva, Rivard, Sachs, Davids)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth S","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Brigham and Women\u2019s Hospital, Boston, MA (Davis, Kenzik)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anays","family":"Murillo","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Chan, Murillo, Ng, Beresneva, Rivard, Sachs, Davids)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sing Chau","family":"Ng","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Chan, Murillo, Ng, Beresneva, Rivard, Sachs, Davids)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Beresneva","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Chan, Murillo, Ng, Beresneva, Rivard, Sachs, Davids)"},{"name":"Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (Myers, Chan, Beresneva, Rivard, Sachs, Davids)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Rivard","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Chan, Murillo, Ng, Beresneva, Rivard, Sachs, Davids)"},{"name":"Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (Myers, Chan, Beresneva, Rivard, Sachs, Davids)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teviah","family":"Sachs","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Chan, Murillo, Ng, Beresneva, Rivard, Sachs, Davids)"},{"name":"Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (Myers, Chan, Beresneva, Rivard, Sachs, Davids)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer S","family":"Davids","sequence":"additional","affiliation":[{"name":"From the Department of Surgery, Boston Medical Center, Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (Myers, Chan, Murillo, Ng, Beresneva, Rivard, Sachs, Davids)"},{"name":"Department of Surgery, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (Myers, Chan, Beresneva, Rivard, Sachs, Davids)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly M","family":"Kenzik","sequence":"additional","affiliation":[{"name":"Department of Surgery, Brigham and Women\u2019s Hospital, Boston, MA (Davis, Kenzik)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"R2-20260219","doi-asserted-by":"crossref","first-page":"2285","DOI":"10.1007\/s11605-019-04270-5","article-title":"Disparity of colon 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