Examining the Association between Healthcare Utilization and Clinical Characteristics among Cancer Patients in a Safety Net Health System

Abstract

Objective-The goal of this study was to examine the association between available patient and clinical characteristics and healthcare utilization in a cohort of breast, lung, and colorectal cancer patients within a safety-net hospital system. Methods-Data for 979 breast, lung, and colorectal cancer patients admitted to a large, urban hospital for the year 2010 were extracted from the electronic medical record (EMR). Univariate and multivariate logistic regression analyses were performed to examine the association between relevant independent variables that were able to be captured from the EMR in discrete fields, emergency room (ER) utilization, and hospitalizations among members of the cohort. Spearman correlation coefficients to test the correlations between nonsteroidal anti-inflammatory drug and opioid prescriptions and healthcare utilization were also calculated. Results-Of the 979 patients, 22% were 65 years and older, 43% were non-Hispanic black, 42% had Medicare, and 56% had colorectal cancer. Patient and clinical characteristics that were associated with increased ER utilization, included Hispanic ethnicity

Emotional distress and future healthcare utilization in oncology populations: A systematic review

“…Given the nature of the study question, we cannot assume that questionnaire response patterns alone were indicative of future healthcare utilization. Within the included study sample, few analyses controlled for well‐known prognostic factors like disease severity and presence of comorbidities that may contribute to healthcare utilization 65,66 . Additionally, healthcare utilization was defined broadly in the current review, therefore, there was heterogeneity in the definition and measurement of the outcome variable of interest which also limits our ability to generalize the current results.…”

“…Within the included study sample, few analyses controlled for well-known prognostic factors like disease severity and presence of comorbidities that may contribute to healthcare utilization. 65,66 Additionally, healthcare utilization was defined broadly in the current review, therefore, there was heterogeneity in the definition and measurement of the outcome variable of interest which also limits our ability to generalize the current results. As measurement of healthcare utilization is pertinent to national policy, cancer center rankings, and accreditation standards (e.g., hospital readmission rates post-surgery or post-chemotherapy), well-controlled prospective studies utilizing electronic health record data as well as validated healthcare utilization questionnaires 67 are warranted to further explore this relationship.…”

Factors associated with unscheduled care use by cancer decedents: a systematic review with narrative synthesis

“…Some studies found that hospice enrolment was involved in a 1.5-2 fold decrease in ED attendances 13,37,38 . Patients who had access to specialist palliative care teams were less likely to attend ED than patients without palliative care access 18,39 .…”

“…There was more heterogeneity in the findings associated with race (4 studies), and rurality (5 studies). The majority of studies that examined race/ethnicity reported that cancer decedents with non-white ethnicity were more likely to use unscheduled care compared to those of white ethnicity 10,14,18,19 . While there were some conflicting results 16 , most studies reporting on rurality found that cancer decedents who lived living in an urban setting were more likely to use the ED than those who lived in rural or semi-rural areas 10,11,13,16 .…”

“…There was a significant amount of consistent evidence supporting the association between hospice enrolment and unscheduled care use by cancer decedents (12 studies). Being enrolled in a hospice programme was consistently associated with a lower use of unscheduled care 5,7,15,18,34,[37][38][39] . Some studies found that hospice enrolment was involved in a 1.5-2 fold decrease in ED attendances 13,37,38 .…”