Department of Epidemiology and Cancer Registry, CancerCare Manitoba, 675 McDermot Avenue, Winnipeg, MB R3E 0V9, Canada.
Department of Community Health Sciences, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, 750 Bannatyne Avenue, Winnipeg, MB R3E 0W2, Canada.
Curr Oncol. 2023 Jul 18;30(7):6771-6785. doi: 10.3390/curroncol30070496.
The urgent cancer care (UCC) clinic at CancerCare Manitoba (CCMB) opened in 2013 to provide care to individuals diagnosed with cancer and serious blood disorders experiencing complications from the underlying disorder or its treatment. This study examined the impact of the UCC clinic on other health care utilization in Winnipeg, Manitoba, Canada. An interrupted time series study design was used to compare the rates of emergency department (ED) visits, primary care clinician (PCC) visits, and hospitalizations from 1 January 2010 to 31 December 2015. Rates of ED visits were also stratified by ED location, severity, and cancer type. We found a 6% (95% CI 1.00-1.13, -value = 0.0389) increase in PCC visits, a 7% (95% CI 0.99-1.15, -value = 0.0737) increase in hospitalizations, a 4% (95% CI 0.86-1.08, -value = 0.5053) decrease in the rate of ED visits, and a 3% (95% CI 0.92-1.17, -value = 0.5778) increase in the rate of ED visits during the UCC clinic hours after the UCC clinic opened. The implementation of the UCC clinic had minimal impact on health care utilization. Future work should examine the impact of the UCC clinic on other aspects of healthcare utilization (e.g., number of tests ordered and time spent waiting in CCMB's main clinics) and patient quality of life and patient and health care provider experience.
加拿大马尼托巴省癌症关怀中心的紧急癌症护理 (UCC) 诊所于 2013 年开业,旨在为诊断患有癌症和严重血液疾病的个人提供护理,这些患者因潜在疾病或其治疗而出现并发症。本研究考察了 UCC 诊所对加拿大马尼托巴省温尼伯市其他医疗保健利用的影响。采用中断时间序列研究设计,比较了 2010 年 1 月 1 日至 2015 年 12 月 31 日期间急诊部 (ED) 就诊、初级保健医生 (PCC) 就诊和住院的比例。ED 就诊率还按 ED 位置、严重程度和癌症类型进行分层。我们发现,PCC 就诊率增加了 6%(95%置信区间 1.00-1.13,-值=0.0389),住院率增加了 7%(95%置信区间 0.99-1.15,-值=0.0737),ED 就诊率下降了 4%(95%置信区间 0.86-1.08,-值=0.5053),UCC 诊所开业后 UCC 诊所营业时间内 ED 就诊率增加了 3%(95%置信区间 0.92-1.17,-值=0.5778)。UCC 诊所的实施对医疗保健的利用影响很小。未来的工作应该研究 UCC 诊所对医疗保健利用的其他方面(例如,在 CCMB 主要诊所中检查数量和等待时间)以及患者生活质量和患者和医疗保健提供者体验的影响。