26 March 2020

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.

Abstract

Objective
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.

Design
Cross-sectional claims data study.

Setting
The Netherlands.

Participants
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.

Results
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.

Conclusions
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.

Publication
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


BRAINMODEL: precision medicine for brain disorders

25 October 2021

A team of researchers from Radboudumc, VU Amsterdam and other institutes is going to look for new and better ways to heal developmental disorders in the brain.

read more

How healthy is James Bond? - A flu to a kill No time to die: the pathogens surrounding secret agent 007

21 October 2021

James Bond made a total of 25 films between 1962 and 2021. In all those films, secret agent 007 washed his hands only twice, even though he often stayed in not so hygienic places with considerable health risks. Radboudumc researchers examined all the health risks in the 47 countries Bond visited.

read more

Surprisingly dominant cause underlying type I congenital defect of glycosylation

21 October 2021

Alex Garanto, Melissa Bärenfänger, Mirian Janssen, and Dirk Lefeber published a new study, identifying a surprisingly dominant genetic cause underlying type I congenital defect of glycosylation with neuromusculoskeletal phenotypes.

read more

Sensitive blood-test as a patient-friendly alternative for bone marrow-based cancer monitoring

20 October 2021

Hans Jacobs and Pieter Langerhorst, theme Cancer development and immune defense, and colleagues are one step closer to implementation of personalized diagnostics for bone marrow-based cancer monitoring.

read more

Register for peer coaching for RIMLS PhD candidates

20 October 2021

As a PhD candidate, you are in the lead of your own learning process, but you don’t need to do this alone. Register for the peer-coaching group ‘Stay in the lead – Together’ before 11 November 2021.

read more