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.


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.

The Netherlands.

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

Research into treatment for bladder pain syndrome will now be reimbursed

4 August 2021 Bladder pain syndrome, also called interstitial cystitis, is a chronic benign condition of the urinary bladder read more

Obesity increases risk of death in uterine cancer PhD defense of Hannah Donkers on 22 April

22 April 2021 Research by Hannah Donkers shows that obesity causes a worse survival rate in women with uterine cancer. In addition, it appears that lower socioeconomic class and anemia also contribute. read more

Physiotherapy is important to the recovery of patients with the coronavirus

26 March 2020 Patients who have been infected with the coronavirus and admitted to the hospital for this reason should receive physiotherapy as soon as their condition allows. This is the view expressed by physiotherapists and researchers from the Radboudumc in a set of joint treatment recommendations. read more

People-like-me treatment for intermittent claudication Personalized approach for patients

27 February 2020 Radboudumc, with the University of Colorado, ClaudicatioNet and Harteraad, has developed a method to better treat people with intermittent claudication. This method, by RIHS researcher Thomas Hoogeboom among others, enables physiotherapists to coordinate the care process with the patient better. read more

General practitioners rarely order images for back problems

4 February 2020 8% Of all general practitioners regularly order imaging for patients who have lower-back pain without severe symptoms. Such imaging does not contribute to the treatment. This is indicated by the results from the Doen of Laten? project, a study conducted by Radboudumc, the LUMC and VGZ Cooperation. read more