Department of nursing, Umeå University, Umeå, Sweden.
Regional Cancer Center, Stockholm-Gotland, Sweden.
Eur J Cancer Care (Engl). 2021 Mar;30(2):e13361. doi: 10.1111/ecc.13361. Epub 2020 Nov 20.
Improved cancer treatments and models of care (such as early palliative care) has developed during recent years. Aspects of healthcare utilisation-unplanned care have been used for evaluation of coordination and quality. The aim was to explore factors associated with cancer healthcare utilisation, during the first year after a cancer diagnosis.
Population-based registry and patient-reported data, (The European Organisation of Research and Treatment of Cancer (EORTC), QLQ- C30 questionnaire and study-specific questions) were collected. Descriptive statistics and multivariate regression models were performed.
The sample consists of 1718 patients (haematological, gynaecological, upper gastrointestinal and head and neck cancers). Living alone were associated with unplanned hospital admissions (OR 1.35; 95% CI [1.15, 1.59], p < 0.001). Patients with specialised palliative home care had a higher likelihood of unplanned hospital admissions, (OR 4.35; 95% CI [3.22-5.91], p < 0.001) and re-admissions within 30 days, (OR, 5.8; 95% CI [4.12-8.19], p < 0.001).
Sociodemographic and clinical factors, such as living alone and disease stage, is associated with healthcare utilisation. Patients with specialised palliative home care report lower levels of HRQoL and higher levels of unplanned care, and our findings stresses the importance of a holistic view when planning care.
近年来，癌症治疗方法和护理模式（如早期姑息治疗）得到了改进。医疗利用方面——非计划性护理，已被用于评估协调和质量。目的是探讨癌症诊断后第一年与癌症医疗保健利用相关的因素。
收集了基于人群的注册和患者报告数据（欧洲癌症研究与治疗组织（EORTC），QLQ-C30 问卷和特定于研究的问题）。进行了描述性统计和多变量回归模型分析。
样本包括 1718 名患者（血液、妇科、上消化道和头颈部癌症）。独居与非计划性住院有关（OR 1.35；95%CI [1.15, 1.59]，p<0.001）。有专门姑息治疗的家庭护理的患者更有可能接受非计划性住院治疗（OR 4.35；95%CI [3.22-5.91]，p<0.001）和 30 天内再次入院（OR，5.8；95%CI [4.12-8.19]，p<0.001）。
社会人口统计学和临床因素，如独居和疾病阶段，与医疗保健的利用有关。有专门姑息治疗的家庭护理的患者报告的 HRQoL 水平较低，非计划性护理水平较高，我们的研究结果强调在规划护理时采取整体观点的重要性。
