Associations between symptoms with healthcare utilization and death in advanced cancer patients
Introduction There is limited data about assessments that are associated with increased utilization of medical services among advanced oncology patients (AOPs). We aimed to identify factors related to healthcare utilization and death in AOP. Methods AOPs at a comprehensive cancer center were enrolle...
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| Veröffentlicht in: | Supportive care in cancer 2023-03, Vol.31 (3), p.183-183, Article 183 |
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| creator | Farrell, Megan M. Jiang, Cherry Moss, Gabriel Daly, Barbara Weinstein, Elizabeth Kemmann, Matthew Gupta, Mona Lee, Richard T. |
| description | Introduction
There is limited data about assessments that are associated with increased utilization of medical services among advanced oncology patients (AOPs). We aimed to identify factors related to healthcare utilization and death in AOP.
Methods
AOPs at a comprehensive cancer center were enrolled in a Center for Medicare and Medicaid Innovation program. Participants completed the Edmonton Symptom Assessment Scale (ESAS) and the Functional Assessment of Cancer Therapy–General (FACT-G) scale. We examined factors associated with palliative care (PC), acute care (AC), emergency room (ER), hospital admissions (HA), and death.
Results
In all, 817 AOPs were included in these analyses with a median age of 69. They were generally female (58.7%), white (61.4%), stage IV (51.6%), and represented common cancers (31.5% GI, 25.2% thoracic, 14.3% gynecologic). ESAS pain, anxiety, and total score were related to more PC visits (B=0.31, 95% CI [0.21, 0.40],
p |
| doi_str_mv | 10.1007/s00520-023-07618-5 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9950186</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A738440848</galeid><sourcerecordid>A738440848</sourcerecordid><originalsourceid>FETCH-LOGICAL-c541t-434800ac9acffd79685910823acdc7357d660302f17e98d813fcf5bf2bf0a2e73</originalsourceid><addsrcrecordid>eNp9kl9vFCEUxYnR2LX6BXwwk_jiy9QLDAPzYrJp_Jc08UWfCQuXXZoZWGG2TfvpZXdra40xPBC4v3MulxxCXlM4owDyfQEQDFpgvAXZU9WKJ2RBO85byfnwlCxg6GjbcSFOyItSLgGolII9Jye8V4yCkAuil6UkG8wcUizNCudrxNiUm2k7p6k012HeNBs047yxJmOzm8MYbg90Y6JrHJoKhHpwVyZadI3db7nZVgbjXF6SZ96MBV_d7afkx6eP38-_tBffPn89X160VnR0ro_sFICxg7HeOzn0SgwUFOPGOiu5kK7vgQPzVOKgnKLcWy9Wnq08GIaSn5IPR9_tbjWhs7V3NqPe5jCZfKOTCfpxJYaNXqcrPQwCqOqrwbs7g5x-7rDMegrF4jiaiGlXNJNy4J3gjFb07V_oZdrlWMc7UEzIQckHam1G1CH6VPvavaleSq66DlSnKnX2D6ouh1OwKaIP9f6RgB0FNqdSMvr7GSnofSz0MRa6xkIfYqFFFb3583fuJb9zUAF-BEotxTXmh5H-Y_sL3njDUA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2779257987</pqid></control><display><type>article</type><title>Associations between symptoms with healthcare utilization and death in advanced cancer patients</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Farrell, Megan M. ; Jiang, Cherry ; Moss, Gabriel ; Daly, Barbara ; Weinstein, Elizabeth ; Kemmann, Matthew ; Gupta, Mona ; Lee, Richard T.</creator><creatorcontrib>Farrell, Megan M. ; Jiang, Cherry ; Moss, Gabriel ; Daly, Barbara ; Weinstein, Elizabeth ; Kemmann, Matthew ; Gupta, Mona ; Lee, Richard T.</creatorcontrib><description>Introduction
There is limited data about assessments that are associated with increased utilization of medical services among advanced oncology patients (AOPs). We aimed to identify factors related to healthcare utilization and death in AOP.
Methods
AOPs at a comprehensive cancer center were enrolled in a Center for Medicare and Medicaid Innovation program. Participants completed the Edmonton Symptom Assessment Scale (ESAS) and the Functional Assessment of Cancer Therapy–General (FACT-G) scale. We examined factors associated with palliative care (PC), acute care (AC), emergency room (ER), hospital admissions (HA), and death.
Results
In all, 817 AOPs were included in these analyses with a median age of 69. They were generally female (58.7%), white (61.4%), stage IV (51.6%), and represented common cancers (31.5% GI, 25.2% thoracic, 14.3% gynecologic). ESAS pain, anxiety, and total score were related to more PC visits (B=0.31, 95% CI [0.21, 0.40],
p
<0.001; B=0.24 [0.12, 0.36],
p
<0.001; and B=0.038 [0.02, 0.06],
p
=0.001, respectively). Total FACT-G score and physical subscale were related to total PC visits (B=−0.021 [−0.037, −0.006],
p
=0.008 and B=−0.181 [−0.246, −0.117],
p
<0.001, respectively). Lower FACT-G social subscale scores were related to more ER visits (B=−0.03 [−0.53, −0.004],
p
=0.024), while increased tiredness was associated with fewer AC visits (B=−0.039 [−0.073, −0.006],
p
=0.023). Higher total ESAS scores were related to death within 30 days (OR=0.87 [0.76, 0.98],
p
=0.027).
Conclusions
The ESAS and FACT-G assessments were linked to PC and AC visits and death. These assessments may be useful for identifying AOPs that would benefit from routine PC.</description><identifier>ISSN: 0941-4355</identifier><identifier>EISSN: 1433-7339</identifier><identifier>DOI: 10.1007/s00520-023-07618-5</identifier><identifier>PMID: 36821057</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Analysis ; Cancer ; Cancer patients ; Care and treatment ; Death & dying ; Emergency medical services ; Evaluation ; Female ; Health services utilization ; Humans ; Innovations ; Medicaid ; Medical care ; Medical colleges ; Medicare ; Medicine ; Medicine & Public Health ; Mortality ; Neoplasms - complications ; Neoplasms - therapy ; Nursing ; Nursing Research ; Oncology ; Pain - diagnosis ; Pain Medicine ; Palliative Care ; Palliative treatment ; Patient Acceptance of Health Care ; Quality of life ; Rehabilitation Medicine ; Symptom Assessment ; Symptom management ; United States ; Utilization</subject><ispartof>Supportive care in cancer, 2023-03, Vol.31 (3), p.183-183, Article 183</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>COPYRIGHT 2023 Springer</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-434800ac9acffd79685910823acdc7357d660302f17e98d813fcf5bf2bf0a2e73</citedby><cites>FETCH-LOGICAL-c541t-434800ac9acffd79685910823acdc7357d660302f17e98d813fcf5bf2bf0a2e73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00520-023-07618-5$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00520-023-07618-5$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36821057$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Farrell, Megan M.</creatorcontrib><creatorcontrib>Jiang, Cherry</creatorcontrib><creatorcontrib>Moss, Gabriel</creatorcontrib><creatorcontrib>Daly, Barbara</creatorcontrib><creatorcontrib>Weinstein, Elizabeth</creatorcontrib><creatorcontrib>Kemmann, Matthew</creatorcontrib><creatorcontrib>Gupta, Mona</creatorcontrib><creatorcontrib>Lee, Richard T.</creatorcontrib><title>Associations between symptoms with healthcare utilization and death in advanced cancer patients</title><title>Supportive care in cancer</title><addtitle>Support Care Cancer</addtitle><addtitle>Support Care Cancer</addtitle><description>Introduction
There is limited data about assessments that are associated with increased utilization of medical services among advanced oncology patients (AOPs). We aimed to identify factors related to healthcare utilization and death in AOP.
Methods
AOPs at a comprehensive cancer center were enrolled in a Center for Medicare and Medicaid Innovation program. Participants completed the Edmonton Symptom Assessment Scale (ESAS) and the Functional Assessment of Cancer Therapy–General (FACT-G) scale. We examined factors associated with palliative care (PC), acute care (AC), emergency room (ER), hospital admissions (HA), and death.
Results
In all, 817 AOPs were included in these analyses with a median age of 69. They were generally female (58.7%), white (61.4%), stage IV (51.6%), and represented common cancers (31.5% GI, 25.2% thoracic, 14.3% gynecologic). ESAS pain, anxiety, and total score were related to more PC visits (B=0.31, 95% CI [0.21, 0.40],
p
<0.001; B=0.24 [0.12, 0.36],
p
<0.001; and B=0.038 [0.02, 0.06],
p
=0.001, respectively). Total FACT-G score and physical subscale were related to total PC visits (B=−0.021 [−0.037, −0.006],
p
=0.008 and B=−0.181 [−0.246, −0.117],
p
<0.001, respectively). Lower FACT-G social subscale scores were related to more ER visits (B=−0.03 [−0.53, −0.004],
p
=0.024), while increased tiredness was associated with fewer AC visits (B=−0.039 [−0.073, −0.006],
p
=0.023). Higher total ESAS scores were related to death within 30 days (OR=0.87 [0.76, 0.98],
p
=0.027).
Conclusions
The ESAS and FACT-G assessments were linked to PC and AC visits and death. These assessments may be useful for identifying AOPs that would benefit from routine PC.</description><subject>Aged</subject><subject>Analysis</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Death & dying</subject><subject>Emergency medical services</subject><subject>Evaluation</subject><subject>Female</subject><subject>Health services utilization</subject><subject>Humans</subject><subject>Innovations</subject><subject>Medicaid</subject><subject>Medical care</subject><subject>Medical colleges</subject><subject>Medicare</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Neoplasms - complications</subject><subject>Neoplasms - therapy</subject><subject>Nursing</subject><subject>Nursing Research</subject><subject>Oncology</subject><subject>Pain - diagnosis</subject><subject>Pain Medicine</subject><subject>Palliative Care</subject><subject>Palliative treatment</subject><subject>Patient Acceptance of Health Care</subject><subject>Quality of life</subject><subject>Rehabilitation Medicine</subject><subject>Symptom Assessment</subject><subject>Symptom management</subject><subject>United States</subject><subject>Utilization</subject><issn>0941-4355</issn><issn>1433-7339</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kl9vFCEUxYnR2LX6BXwwk_jiy9QLDAPzYrJp_Jc08UWfCQuXXZoZWGG2TfvpZXdra40xPBC4v3MulxxCXlM4owDyfQEQDFpgvAXZU9WKJ2RBO85byfnwlCxg6GjbcSFOyItSLgGolII9Jye8V4yCkAuil6UkG8wcUizNCudrxNiUm2k7p6k012HeNBs047yxJmOzm8MYbg90Y6JrHJoKhHpwVyZadI3db7nZVgbjXF6SZ96MBV_d7afkx6eP38-_tBffPn89X160VnR0ro_sFICxg7HeOzn0SgwUFOPGOiu5kK7vgQPzVOKgnKLcWy9Wnq08GIaSn5IPR9_tbjWhs7V3NqPe5jCZfKOTCfpxJYaNXqcrPQwCqOqrwbs7g5x-7rDMegrF4jiaiGlXNJNy4J3gjFb07V_oZdrlWMc7UEzIQckHam1G1CH6VPvavaleSq66DlSnKnX2D6ouh1OwKaIP9f6RgB0FNqdSMvr7GSnofSz0MRa6xkIfYqFFFb3583fuJb9zUAF-BEotxTXmh5H-Y_sL3njDUA</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Farrell, Megan M.</creator><creator>Jiang, Cherry</creator><creator>Moss, Gabriel</creator><creator>Daly, Barbara</creator><creator>Weinstein, Elizabeth</creator><creator>Kemmann, Matthew</creator><creator>Gupta, Mona</creator><creator>Lee, Richard T.</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2R</scope><scope>M2S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230301</creationdate><title>Associations between symptoms with healthcare utilization and death in advanced cancer patients</title><author>Farrell, Megan M. ; Jiang, Cherry ; Moss, Gabriel ; Daly, Barbara ; Weinstein, Elizabeth ; Kemmann, Matthew ; Gupta, Mona ; Lee, Richard T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-434800ac9acffd79685910823acdc7357d660302f17e98d813fcf5bf2bf0a2e73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Analysis</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Care and treatment</topic><topic>Death & dying</topic><topic>Emergency medical services</topic><topic>Evaluation</topic><topic>Female</topic><topic>Health services utilization</topic><topic>Humans</topic><topic>Innovations</topic><topic>Medicaid</topic><topic>Medical care</topic><topic>Medical colleges</topic><topic>Medicare</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Neoplasms - complications</topic><topic>Neoplasms - therapy</topic><topic>Nursing</topic><topic>Nursing Research</topic><topic>Oncology</topic><topic>Pain - diagnosis</topic><topic>Pain Medicine</topic><topic>Palliative Care</topic><topic>Palliative treatment</topic><topic>Patient Acceptance of Health Care</topic><topic>Quality of life</topic><topic>Rehabilitation Medicine</topic><topic>Symptom Assessment</topic><topic>Symptom management</topic><topic>United States</topic><topic>Utilization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Farrell, Megan M.</creatorcontrib><creatorcontrib>Jiang, Cherry</creatorcontrib><creatorcontrib>Moss, Gabriel</creatorcontrib><creatorcontrib>Daly, Barbara</creatorcontrib><creatorcontrib>Weinstein, Elizabeth</creatorcontrib><creatorcontrib>Kemmann, Matthew</creatorcontrib><creatorcontrib>Gupta, Mona</creatorcontrib><creatorcontrib>Lee, Richard T.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Supportive care in cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Farrell, Megan M.</au><au>Jiang, Cherry</au><au>Moss, Gabriel</au><au>Daly, Barbara</au><au>Weinstein, Elizabeth</au><au>Kemmann, Matthew</au><au>Gupta, Mona</au><au>Lee, Richard T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Associations between symptoms with healthcare utilization and death in advanced cancer patients</atitle><jtitle>Supportive care in cancer</jtitle><stitle>Support Care Cancer</stitle><addtitle>Support Care Cancer</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>31</volume><issue>3</issue><spage>183</spage><epage>183</epage><pages>183-183</pages><artnum>183</artnum><issn>0941-4355</issn><eissn>1433-7339</eissn><abstract>Introduction
There is limited data about assessments that are associated with increased utilization of medical services among advanced oncology patients (AOPs). We aimed to identify factors related to healthcare utilization and death in AOP.
Methods
AOPs at a comprehensive cancer center were enrolled in a Center for Medicare and Medicaid Innovation program. Participants completed the Edmonton Symptom Assessment Scale (ESAS) and the Functional Assessment of Cancer Therapy–General (FACT-G) scale. We examined factors associated with palliative care (PC), acute care (AC), emergency room (ER), hospital admissions (HA), and death.
Results
In all, 817 AOPs were included in these analyses with a median age of 69. They were generally female (58.7%), white (61.4%), stage IV (51.6%), and represented common cancers (31.5% GI, 25.2% thoracic, 14.3% gynecologic). ESAS pain, anxiety, and total score were related to more PC visits (B=0.31, 95% CI [0.21, 0.40],
p
<0.001; B=0.24 [0.12, 0.36],
p
<0.001; and B=0.038 [0.02, 0.06],
p
=0.001, respectively). Total FACT-G score and physical subscale were related to total PC visits (B=−0.021 [−0.037, −0.006],
p
=0.008 and B=−0.181 [−0.246, −0.117],
p
<0.001, respectively). Lower FACT-G social subscale scores were related to more ER visits (B=−0.03 [−0.53, −0.004],
p
=0.024), while increased tiredness was associated with fewer AC visits (B=−0.039 [−0.073, −0.006],
p
=0.023). Higher total ESAS scores were related to death within 30 days (OR=0.87 [0.76, 0.98],
p
=0.027).
Conclusions
The ESAS and FACT-G assessments were linked to PC and AC visits and death. These assessments may be useful for identifying AOPs that would benefit from routine PC.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36821057</pmid><doi>10.1007/s00520-023-07618-5</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0941-4355 |
| ispartof | Supportive care in cancer, 2023-03, Vol.31 (3), p.183-183, Article 183 |
| issn | 0941-4355 1433-7339 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9950186 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Aged Analysis Cancer Cancer patients Care and treatment Death & dying Emergency medical services Evaluation Female Health services utilization Humans Innovations Medicaid Medical care Medical colleges Medicare Medicine Medicine & Public Health Mortality Neoplasms - complications Neoplasms - therapy Nursing Nursing Research Oncology Pain - diagnosis Pain Medicine Palliative Care Palliative treatment Patient Acceptance of Health Care Quality of life Rehabilitation Medicine Symptom Assessment Symptom management United States Utilization |
| title | Associations between symptoms with healthcare utilization and death in advanced cancer patients |
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