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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.

Authors

E. G. Boland

K. T. Tay

A. Khamis



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
Electronic ISSN 1433-7339
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

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0

Copyright Statement
© Crown 2024.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.




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