HEALTH CARE RESOURCE UTILIZATION IN THE YEAR PRIOR TO DEATH AMONG PATIENTS WITH LUNG CANCER AND COPD IN SASKATCHEWAN

Abstract

SESSION TITLE: Lung Cancer: Procedures, Outcomes, and Palliative CareSESSION TYPE: Rapid Fire Original InvPRESENTED ON: 10/17/2022 12:15 pm - 1:15 pmPURPOSE: Lung Cancer (LC) and Chronic obstructive pulmonary disease (COPD) are major causes of mortality and morbidity worldwide. Both diseases are associated with high healthcare resource burdens that rise substantially in the months prior to death. Previous work has demonstrated distinct healthcare utilization patterns among patients with LC and COPD, with the diagnosis of LC being associated with higher odds of hospitalization, palliative care services, and opioid use compared to COPD. Limited knowledge exists about resource use in the care of those with concurrent LC and COPD. Here, we aim to describe healthcare resource utilization among patients with LC, COPD and both diagnoses in a Saskatchewan cohortMETHODS: Using Saskatchewan cancer registry (SCR) linked with health administrative data, we conducted a retrospective cohort analysis of healthcare utilization among Saskatchewan residents, age 35 years and older diagnosed with primary LC and/or COPD between January 1, 2000 and December 31, 2015. Patients were stratified into three groups based on diagnosis – 1) LC; 2) COPD; and 3) Concurrent LC and COPD. Deceased individuals were identified within each group at three specific time periods - 2004 and 2005; 2009 and 2010; 2014 and 2015. Healthcare utilization was captured in the year prior to death, including palliative care (PC) utilization, referral to home care, opioid prescriptions, physician visits, hospitalizations, and admission to ICU.RESULTS: A total of 44786 patients were included in the cohort - 1410(3.2%) LC, 41113(91.8%) COPD, and 2263(5.1%) COPD and LC. Patients with LC and combined LC and COPD were more likely to receive palliative care than patients with COPD alone – 67% and 65% vs 27%, respectively. Similarly, patients with COPD were least likely to receive home care (11.3%), opioid prescriptions (34.4%) or be hospitalized at the time of death (34.4%) compared to those with LC and combined LC and COPD (67.3% and 67.0% home care, 34.4% and 39.4% opioid prescriptions, 58.4% and 59.4% hospitalized at the time of death respectively). Patients with LC had the highest physician visit (34 per patient year of follow up), hospitalizations (4.8 per patient year of follow up) and lowest ICU rates (0.17 per patient year of follow up).CONCLUSIONS: Notable differences exist in the healthcare resource utilization patterns between patients with LC, COPD and combined LC and COPD. The diagnosis of LC significantly increases the likelihood of hospitalization, referral to home care, and opioid treatment.CLINICAL IMPLICATIONS: The findings may reflect distinct approaches to the management of malignancies compared to other lung diseases. Other important considerations include patient demographics along with the local healthcare system factors.DISCLOSURES: Board relationship with Lung Association, Saskatchewan Please note: 2020-present Added 04/15/2022 by Mark Fenton, value=noneNo relevant relationships by Donna GoodridgeNo relevant relationships by Dmitry NeymarkAdvisory Committee Member relationship with Astra Zeneca Please note: > 5 years Added 04/14/2022 by Erika Penz, value=HonorariaAdvisory Committee Member relationship with GlaxoSmithKline Please note: > 5 years Added 04/14/2022 by Erika Penz, value=HonorariaAdvisory Committee Member relationship with Boehringer Ingelheim Please note: $1001 - $5000 by Erika Penz, value=HonorariaRemoved 04/14/2022 by Erika PenzSpeaker/Speaker's Bureau relationship with Astra Zeneca Please note: > 5 years Added 04/14/2022 by Erika Penz, value=HonorariaSpeaker/Speaker's Bureau relationship with Boehringer Ingelheim Please note: > 2 years Added 04/14/2022 by Erika Penz, value=HonorariaConsultant relationship with Astra Zeneca Please note: > 5 years Added 04/14/2022 by Erika Penz, value=Consulting feeConsultant relationship with GlaxoSmithKline Please note: > 5 years Added 04/14/2022 by Erika Penz, value=Consulting feeAdvisory Committee Member relationship with Sanofi Genzyme Please note: 2 years Added 04/14/2022 by Erika Penz, value=HonorariaNo relevant relationships by Nirmal Sidhu SESSION TITLE: Lung Cancer: Procedures, Outcomes, and Palliative Care SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: Lung Cancer (LC) and Chronic obstructive pulmonary disease (COPD) are major causes of mortality and morbidity worldwide. Both diseases are associated with high healthcare resource burdens that rise substantially in the months prior to death. Previous work has demonstrated distinct healthcare utilization patterns among patients with LC and COPD, with the diagnosis of LC being associated with higher odds of hospitalization, palliative care services, and opioid use compared to COPD. Limited knowledge exists about resource use in the care of those with concurrent LC and COPD. Here, we aim to describe healthcare resource utilization among patients with LC, COPD and both diagnoses in a Saskatchewan cohort METHODS: Using Saskatchewan cancer registry (SCR) linked with health administrative data, we conducted a retrospective cohort analysis of healthcare utilization among Saskatchewan residents, age 35 years and older diagnosed with primary LC and/or COPD between January 1, 2000 and December 31, 2015. Patients were stratified into three groups based on diagnosis – 1) LC; 2) COPD; and 3) Concurrent LC and COPD. Deceased individuals were identified within each group at three specific time periods - 2004 and 2005; 2009 and 2010; 2014 and 2015. Healthcare utilization was captured in the year prior to death, including palliative care (PC) utilization, referral to home care, opioid prescriptions, physician visits, hospitalizations, and admission to ICU. RESULTS: A total of 44786 patients were included in the cohort - 1410(3.2%) LC, 41113(91.8%) COPD, and 2263(5.1%) COPD and LC. Patients with LC and combined LC and COPD were more likely to receive palliative care than patients with COPD alone – 67% and 65% vs 27%, respectively. Similarly, patients with COPD were least likely to receive home care (11.3%), opioid prescriptions (34.4%) or be hospitalized at the time of death (34.4%) compared to those with LC and combined LC and COPD (67.3% and 67.0% home care, 34.4% and 39.4% opioid prescriptions, 58.4% and 59.4% hospitalized at the time of death respectively). Patients with LC had the highest physician visit (34 per patient year of follow up), hospitalizations (4.8 per patient year of follow up) and lowest ICU rates (0.17 per patient year of follow up). CONCLUSIONS: Notable differences exist in the healthcare resource utilization patterns between patients with LC, COPD and combined LC and COPD. The diagnosis of LC significantly increases the likelihood of hospitalization, referral to home care, and opioid treatment. CLINICAL IMPLICATIONS: The findings may reflect distinct approaches to the management of malignancies compared to other lung diseases. Other important considerations include patient demographics along with the local healthcare system factors. DISCLOSURES: Board relationship with Lung Association, Saskatchewan Please note: 2020-present Added 04/15/2022 by Mark Fenton, value=none No relevant relationships by Donna Goodridge No relevant relationships by Dmitry Neymark Advisory Committee Member relationship with Astra Zeneca Please note: > 5 years Added 04/14/2022 by Erika Penz, value=Honoraria Advisory Committee Member relationship with GlaxoSmithKline Please note: > 5 years Added 04/14/2022 by Erika Penz, value=Honoraria Advisory Committee Member relationship with Boehringer Ingelheim Please note: $1001 - $5000 by Erika Penz, value=Honoraria Removed 04/14/2022 by Erika Penz Speaker/Speaker's Bureau relationship with Astra Zeneca Please note: > 5 years Added 04/14/2022 by Erika Penz, value=Honoraria Speaker/Speaker's Bureau relationship with Boehringer Ingelheim Please note: > 2 years Added 04/14/2022 by Erika Penz, value=Honoraria Consultant relationship with Astra Zeneca Please note: > 5 years Added 04/14/2022 by Erika Penz, value=Consulting fee Consultant relationship with GlaxoSmithKline Please note: > 5 years Added 04/14/2022 by Erika Penz, value=Consulting fee Advisory Committee Member relationship with Sanofi Genzyme Please note: 2 years Added 04/14/2022 by Erika Penz, value=Honoraria No relevant relationships by Nirmal Sidhu