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Persistent inequalities in unplanned hospitalisation among colon cancer patients across critical phases of their care pathway, England, 2011-13.

Published version
Peer-reviewed

Type

Article

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Authors

Maringe, Camille 
Rachet, Bernard 
Lyratzopoulos, Georgios  ORCID logo  https://orcid.org/0000-0002-2873-7421
Rubio, Francisco Javier 

Abstract

BACKGROUND: Reducing hospital emergency admissions is a key target for all modern health systems. METHODS: We analysed colon cancer patients diagnosed in 2011-13 in England. We screened their individual Hospital Episode Statistics records in the 90 days pre-diagnosis, the 90 days post-diagnosis, and the 90 days pre-death (in the year following diagnosis), for the occurrence of hospital emergency admissions (HEAs). RESULTS: Between a quarter and two thirds of patients experience HEA in the three 90-day periods examined: pre-diagnosis, post-diagnosis and before death. Patients with tumour stage I-III from more deprived backgrounds had higher proportions of HEAs than less deprived patients during all studied periods. This remains even after adjusting for differing distributions of risk factors such as age, sex, comorbidity and stage at diagnosis. CONCLUSIONS: Although in some cases HEAs might be unavoidable or even appropriate, the proportion of HEAs varies by socioeconomic status, even after controlling for the usual patient factors, suggestive of remediable causes of excess emergency healthcare utilisation in patients belonging to higher deprivation groups. Future inquiries should address the potential role of clinical complications, sub-optimal healthcare administration, premature discharge or a lack of social support as potential explanations for these patterns of inequality.

Description

Keywords

Colonic Neoplasms, Emergency Service, Hospital, England, Female, Healthcare Disparities, Hospitalization, Humans, Length of Stay, Male, Neoplasm Staging, Patient Acceptance of Health Care, Social Class

Journal Title

Br J Cancer

Conference Name

Journal ISSN

0007-0920
1532-1827

Volume Title

119

Publisher

Springer Science and Business Media LLC