Healthcare utilization in cancer survivors: six-month longitudinal cohort data

Authors

Nicole Gonzalez, Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA.
K Holly Mead, Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, DC, 20052, USA.
Mandi L. Pratt-Chapman, Department of Medicine, School of Medicine and Health Sciences, George Washington University, Washington, DC, 20052, USA.
Hannah Arem, Healthcare Delivery Research Program, MedStar Health Research Institute, Washington, DC, 20008, USA. Hannah.Arem@medstar.net.

Document Type

Journal Article

Publication Date

5-16-2022

Journal

Cancer causes & control : CCC

DOI

10.1007/s10552-022-01587-6

Keywords

Cancer; Healthcare utilization; Survivorship

Abstract

PURPOSE: To describe healthcare utilization and reasons for delaying medical care and to identify factors that influence high healthcare utilization and care delay among cancer survivors. METHODS: Baseline (n = 991) and 6 month follow-up data (n = 777) were collected among breast, prostate, and colorectal cancer survivors from 32 US cancer centers. Participants completed surveys on healthcare utilization (e.g., number of visits to specific providers) and delay of medical care. We categorized participants as high or low users based on median number of visits. We used logistic regression models to examine factors that predicted high healthcare utilization or delay. RESULTS: Survivors reported a median of 10.5 visits to healthcare providers and 28% reported ever delaying medical care over 6 months. Compared to prostate cancer survivors, breast and colorectal survivors were 2.4 times more likely (CI = 1.2-4.8) and 4 times more likely (CI = 2.2-7.3) to be high healthcare users, respectively. A higher quality of life score predicted high healthcare utilization (OR = 2.4, CI = 2.0-2.8) and delay of medical care (OR = 1.8, CI = 1.5-2.2). Black survivors were 1.5 times more likely than White survivors to be high healthcare users (CI = 1.1-2.0) and respondents reporting a race category other than White or Black were 1.8 times more likely to delay care (CI = 1.3-2.5). Lower levels of self-efficacy predicted greater healthcare use (OR = 0.7, CI = 0.6-0.8) and delay (OR = 0.6, CI = 0.5-0.7). CONCLUSION: Our findings suggest that race, education, marital status, cancer type, time since diagnosis, quality of life, and self-efficacy are associated with both high healthcare utilization and delay among cancer survivors.

APA Citation

Gonzalez, Nicole; Mead, K Holly; Pratt-Chapman, Mandi L.; and Arem, Hannah, "Healthcare utilization in cancer survivors: six-month longitudinal cohort data" (2022). GW Authored Works. Paper 944.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/944

Department

Epidemiology