Patterns of acute hospital and specialist palliative care use among people with non-curative upper gastrointestinal cancer

Boland, E. G.; Tay, K. T.; Khamis, A.; Murtagh, F. E.M.

Abstract

Purpose: Upper gastrointestinal (GI) cancers contribute to 16.7% of UK cancer deaths. These patients make high use of acute hospital services, but detail about palliative care use is lacking. We aimed to determine the patterns of use of acute hospital and hospital specialist palliative care services in patients with advanced non-curative upper GI cancer. Methods: We conducted a service evaluation of hospital use and palliative care for all patients with non-curative upper GI cancer seen in one large hospital, using routinely collected data (2019–2022). We report and characterise hospital admissions and palliative care within the study time period, using descriptive statistics, and multivariable Poisson regression to estimate the unadjusted and adjusted incidence rate ratio of hospital admissions. Results: The total with non-curative upper GI cancer was 960. 86.7% had at least one hospital admission, with 1239 admissions in total. Patients had a higher risk of admission to hospital if: aged ≤ 65 (IRR for 66–75 years 0.71, IRR 76–85 years 0.68; IRR > 85 years 0.53; p < 0.05), or lived in an area of lower socioeconomic status (IMD Deciles 1–5) (IRR 0.90; p < 0.05). Over the 4-year period, the rate of re-admission was higher in patients not referred to palliative care (rate 0.52 readmissions/patient versus rate 1.47 readmissions/patient). Conclusion: People with advanced non-curative gastrointestinal cancer have frequent hospital admissions, especially if younger or from areas of lower socioeconomic status. There is clear association between specialist palliative care referral and reduced risk of hospitalisation. This evidence supports referral to specialist palliative care.

Citation

Boland, E. G., Tay, K. T., Khamis, A., & Murtagh, F. E. (2024). Patterns of acute hospital and specialist palliative care use among people with non-curative upper gastrointestinal cancer. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 32(7), Article 432. https://doi.org/10.1007/s00520-024-08624-x

• Journal Article Type: Article
• Acceptance Date: Jun 1, 2024
• Online Publication Date: Jun 14, 2024
• Publication Date: Jul 1, 2024
• Deposit Date: Jun 24, 2024
• Publicly Available Date: Jun 27, 2024
• Journal: Supportive Care in Cancer
• Print ISSN: 0941-4355
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 7
• Article Number: 432
• DOI: https://doi.org/10.1007/s00520-024-08624-x
• Keywords: Upper gastrointestinal cancer; Non-curative; Specialist palliative care; Hospital admissions; Re-admission 30 days after discharge; Deprivation
• Public URL: https://hull-repository.worktribe.com/output/4717763