Death from cancer : frequent unscheduled care
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OBJECTIVE : To examine the demographic, clinical, and temporal factors associated with cancer decedents being a frequent or very frequent unscheduled care (GP-general practice Out-Of-Hours (GPOOH) and Accident & Emergency (A&E)) attender, in their last year of life. METHODS : Retrospective cohort study, of all 2443 cancer decedents in Tayside, Scotland, over 30- months period up to 06/2015, comparing frequent attenders (5-9 attendances/year) and very frequent attenders (≥10 attendances/year) to infrequent attenders (1-4 attendances/year) and non-attenders. Clinical and demographic datasets were linked to routinely-collected clinical data using the Community Health Index number. Anonymised linked data were analysed in SafeHaven, using binary/multinomial logistic regression, and Generalised Estimating Equations analysis. RESULTS : Frequent attenders were more likely to be older, and have upper gastrointestinal (GI), haematological, breast and ovarian malignancies, and less likely to live in accessible areas or have a late cancer diagnosis. They were more likely to use GPOOH than A&E, less likely to have face-to-face unscheduled care attendances, and less likely to be admitted to hospital following unscheduled care attendance. CONCLUSIONS : Age, cancer type, accessibility and timing of diagnosis relative to death were associated with increased likelihood of being a frequent or very frequent attender at unscheduled care.
Mills , S E E , Buchanan , D , Donnan , P T & Smith , B H 2022 , ' Death from cancer : frequent unscheduled care ' , BMJ Supportive & Palliative Care , vol. Early view . https://doi.org/10.1136/bmjspcare-2021-003448
BMJ Supportive & Palliative Care
Copyright © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
DescriptionFunding: SEEM is funded through a Clinical Academic Fellowship from the Chief Scientist Office (CAF_17_06). Funding for data extraction and storage was through PATCH Scotland and Tayside Oncology Research Foundation Research Grants.
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