In International Journal of Quality Health Care RIHS researcher Femke Atsma showed high healthcare utilization and medical variation in End of Life care in Cancer patients, which was not associated with GP care or long term care.
To examine the regional variation in hospital care utilization in the last 6 months of life of Dutch patients with lung cancer and to test whether higher degrees of hospital utilization coincide with less general practitioner (GP) and long-term care use.
Cross-sectional claims data study.
Patients deceased in 2013-2015 with lung cancer (N = 25 553).
Main outcome measures
We calculated regional medical practice variation scores, adjusted for age, gender and socioeconomic status, for radiotherapy, chemotherapy, CT-scans, emergency room contacts and hospital admission days during the last 6 months of life; Spearman Rank correlation coefficients measured the association between the adjusted regional medical practice variation scores for hospital admissions and ER contacts and GP and long-term care utilization.
The utilization of hospital services in high-using regions is 2.3-3.6 times higher than in low-using regions. The variation was highest in 2015 and lowest in 2013. For all 3 years, hospital care was not significantly correlated with out-of-hospital care at a regional level.
Hospital care utilization during the last 6 months of life of patients with lung cancer shows regional medical practice variation over the course of multiple years and seems to increase. Higher healthcare utilization in hospitals does not seem to be associated with less intensive GP and long-term care. In-depth research is needed to explore the causes of the variation and its relation to quality of care provided at the level of daily practice.
Regional variation in hospital care at the end-of-life of Dutch patients with lung cancer exists and is not correlated with primary and long-term care.
de Man Y, Groenewoud S, Oosterveld-Vlug MG, Brom L, Onwuteaka-Philipsen BD, Westert GP, Atsma F.
Related news items
Biomarkers found in COVID-19 patients support bradykinin hypothesis29 May 2020
A study into inflammatory substances in the blood of COVID-19 patients supports the hypothesis that kinins could play a role in the respiratory problems experienced by critically ill COVID-19 patients in IC. This discovery, published at MedRxiv, could lead to the development of new treatments.read more
Introducing OnePlanet Research Center webinar 5 June, 16:00 hrs.29 May 2020
OnePlanet Research Center develops digital technologies to create a society in which everyone can live a healthy life and has access to healthy and sustainable food. Radboudumc and Radboud University are amongst the founding partners. Find out what OnePlanet can do for you in this online session.read more
The impact of sex and gender in the COVID-19 pandemic29 May 2020
The case study of Sabine Oertelt-Prigione, developed by the European Commission’s H2020 Expert Group to update and expand "Gendered Innovations/Innovation through Gender", examines the impact of sex and gender in the current COVID-19 pandemic.read more
Terrestrial bacteria can grow on nutrients from space26 May 2020
Researchers from the Radboudumc describe in an article in Astrobiology that bacteria can survive on an 'extraterrestrial diet', which affected their pathogenic potential.read more