Article (Scientific journals)
Long-term health-care utilisation in older patients with cancer and the association with the Geriatric 8 screening tool: a retrospective analysis using linked clinical and population-based data in Belgium.
Depoorter, Victoria; Vanschoenbeek, Katrijn; Decoster, Lore et al.
2023In The Lancet Healthy Longevity, 4 (7), p. 326 - e336
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Keywords :
Humans; Aged; Retrospective Studies; Belgium/epidemiology; Patient Acceptance of Health Care; Early Detection of Cancer; Neoplasms/diagnosis; Neoplasms/epidemiology; Neoplasms/therapy; Belgium; Neoplasms; Health (social science); Geriatrics and Gerontology; Psychiatry and Mental Health; Family Practice
Abstract :
[en] [en] BACKGROUND: Little evidence is available on the long-term health-care utilisation of older patients with cancer and whether this is associated with geriatric screening results. We aimed to evaluate long-term health-care utilisation among older patients after cancer diagnosis and the association with baseline Geriatric 8 (G8) screening results. METHODS: For this retrospective analysis, we included data from three cohort studies for patients (aged ≥70 years) with a new cancer diagnosis who underwent G8 screening between Oct 19, 2009 and Feb 27, 2015, and who survived more than 3 months after G8 screening. The clinical data were linked to cancer registry and health-care reimbursement data for long-term follow-up. The occurrence of outcomes (inpatient hospital admissions, emergency department visits, use of intensive care, contacts with general practitioner [GP], contacts with a specialist, use of home care, and nursing home admissions) was assessed in the 3 years after G8 screening. We assessed the association between outcomes and baseline G8 score (normal score [>14] or abnormal [≤14]) using adjusted rate ratios (aRRs) calculated from Poisson regression and using cumulative incidence calculated as a time-to-event analysis with the Kaplan-Meier method. FINDINGS: 7556 patients had a new cancer diagnosis, of whom 6391 patients (median age 77 years [IQR 74-82]) met inclusion criteria and were included. 4110 (64·3%) of 6391 patients had an abnormal baseline G8 score (≤14 of 17 points). In the first 3 months after G8 screening, health-care utilisation peaked and then decreased over time, with the exception of GP contacts and home care days, which remained high throughout the 3-year follow-up period. Compared with patients with a normal baseline G8 score, patients with an abnormal baseline G8 score had more hospital admissions (aRR 1·20 [95% CI 1·15-1·25]; p<0·0001), hospital days (1·66 [1·64-1·68]; p<0·0001), emergency department visits (1·42 [1·34-1·52]; p<0·0001), intensive care days (1·49 [1·39-1·60]; p<0·0001), general practitioner contacts (1·19 [1·17-1·20]; p<0·0001), home care days (1·59 [1·58-1·60]; p<0·0001), and nursing home admissions (16·7% vs 3·1%; p<0·0001) in the 3-year follow-up period. At 3 years, of the 2281 patients with a normal baseline G8 score, 1421 (62·3%) continued to live at home independently and 503 (22·0%) had died. Of the 4110 patients with an abnormal baseline G8 score, 1057 (25·7%) continued to live at home independently and 2191 (53·3%) had died. INTERPRETATION: An abnormal G8 score at cancer diagnosis was associated with increased health-care utilisation in the subsequent 3 years among patients who survived longer than 3 months. FUNDING: Stand up to Cancer, the Flemish Cancer Society.
Disciplines :
Oncology
Author, co-author :
Depoorter, Victoria;  Department of Oncology, KU Leuven, Leuven, Belgium
Vanschoenbeek, Katrijn;  Research Department, Belgian Cancer Registry, Brussels, Belgium
Decoster, Lore;  Department of Medical Oncology, Vrije Universiteit Brussel, University Hospitals Brussels, Brussels, Belgium
Silversmit, Geert;  Research Department, Belgian Cancer Registry, Brussels, Belgium
Debruyne, Philip R;  Division of Medical Oncology, Kortrijk Cancer Centre, AZ Groeninge, Kortrijk, Belgium, Medical Technology Research Centre, School of Life Sciences, Anglia Ruskin University, Cambridge, UK, School of Nursing and Midwifery, University of Plymouth, Plymouth, UK
De Groof, Inge;  Department of Geriatric Medicine, Iridium Network Antwerp, Sint-Augustinus Cancer Center, Wilrijk, Belgium
Bron, Dominique;  Department of Hematology, Institute Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
Cornélis, Frank;  Department of Medical Oncology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
Luce, Sylvie;  Department of Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles, Brussels, Belgium
Focan, Christian;  Department of Oncology, Clinique CHC MontLégia, Liège, Belgium
Verschaeve, Vincent;  Department of Medical Oncology, Grand Hôpital de Charleroi, Charleroi, Belgium
Debugne, Gwenaëlle;  Department of Geriatric Medicine, Centre Hospitalier de Mouscron, Mouscron, Belgium
Langenaeken, Christine;  Department of Medical Oncology, AZ Klina Brasschaat, Brasschaat, Belgium
Van Den Bulck, Heidi;  Department of Medical Oncology, Imelda Hospital, Bonheiden, Belgium
Goeminne, Jean-Charles;  Department of Medical Oncology, Centre Hospitalier Universitaire UCL-Namur, Namur, Belgium
Teurfs, Wesley;  Department of Medical Oncology, ZNA Stuivenberg, Antwerp, Belgium
Jerusalem, Guy  ;  Centre Hospitalier Universitaire de Liège - CHU > > Service d'oncologie médicale
Schrijvers, Dirk;  Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium
Petit, Bénédicte;  Department of Medical Oncology, Centre Hospitalier Jolimont, La Louvière, Belgium
Rasschaert, Marika;  Department of Medical Oncology, University Hospital Antwerp, Edegem, Belgium
Praet, Jean-Philippe;  Department of Geriatric Medicine, Centre Hospitalier Universitaire St-Pierre, Free Universities Brussels, Brussels, Belgium
Vandenborre, Katherine;  Department of Medical Oncology, AZ Vesalius, Tongeren, Belgium
Milisen, Koen;  Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium, Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
Flamaing, Johan;  Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Leuven, Belgium, Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
Kenis, Cindy;  Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium, Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium, Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
Verdoodt, Freija;  Research Department, Belgian Cancer Registry, Brussels, Belgium
Wildiers, Hans;  Department of Oncology, KU Leuven, Leuven, Belgium, Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium. Electronic address: hans.wildiers@uzleuven.be
More authors (17 more) Less
Language :
English
Title :
Long-term health-care utilisation in older patients with cancer and the association with the Geriatric 8 screening tool: a retrospective analysis using linked clinical and population-based data in Belgium.
Publication date :
July 2023
Journal title :
The Lancet Healthy Longevity
eISSN :
2666-7568
Publisher :
Elsevier Ltd, England
Volume :
4
Issue :
7
Pages :
e326 - e336
Peer reviewed :
Peer Reviewed verified by ORBi
Funding text :
The study was funded by a grant from Kom op tegen Kanker (Stand up to Cancer, the Flemish Cancer Society). HW is a recipient of a grant of the Fonds Voor Wetenschappelijk Onderzoek Vlaanderen (1802211N). We thank all the physicians who were involved in this study, particularly Katrien Geboers, who was responsible for data collection in her institution, and Harlinde De Schutter for her contribution in the study design and start-up. We thank all patients and healthcare professionals in the collaborating centers that contributed to this study.
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