text: Medicare Advantage: A Disadvantage of Complex Cancer Surgery Patients (Revise and Resubmit).(with Mustafa Raoof, Gretchen Jacobson, Phililp Ituarte, Oliver Eng, Jae Kim, Yuman Fong)
  PUBLICATIONS:
  1. Liver Resection Improves Survival in Colorectal Cancer Patients- (with Mustafa Raoof, Philip Ituarte, Yuman Fong)- Annals of Surgery (2019)
  Abstract: The aim of this study was to estimate effect of liver section on survival of patients with colorectal cancer liver metastases. As a randomized trial is infeasible and unethical, we test this using instrumental variable (IV) analysis. Liver resection rates across geographical areas provide plausibly exogenous variation in the probability that a given patient gets liver resection. For instance, it is likely that the decision to perform liver resection will depend on the prevailing practice in the patient's area of residence. The underlying assumption is that the area resection rates are exogenous because patients typically do not choose residence based on a need for future liver resection. We used two instruments: 50-mile liver resection rate and Medical Service Study Area liver resection (MALR rate). We calculate the NALR and MSA rate excluding the index patient. Our results suggest that 23.6 months gain in survival for liver resection patients whose treatment choices were influenced by the rates of liver resection in their geographical area.
  2. Systemic Failure to operate on colorectal cancer live metastases in California-(with Mustafa Raoof, Zeljka Jutric, Philip Ituarte, Beigqun Zhao, Gandeep Singh, Laleh Melstron, Susanne Warner, Bryan Clary, Yuman Fong)-Cancer Medicine (2020)
  Abstract: We use California Cancer Registry data from 2000 to 2012 linked to Office of Statewide Health Planning Inpatient database to examine rates of liver resection. Our results suggest that only 10% of the patients with liver metastases underwent liver resection in California. Our results indicate that hospital that initiates first-course of treatment is likely an important determinant of liver resection so patients who get their first diagnosis at a facility that does not routinely perform liver resections are much less likely to get a liver resection.