Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California

Publication Date:
2018-02-03
Publisher:
Wiley-Blackwell
Print ISSN:
0008-543X
Electronic ISSN:
1097-0142
Topics:
Biology
Medicine
Published by:
http://www.wiley.com/wiley-blackwell
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autor Emily E. Johnston, Elysia Alvarez, Olga Saynina, Lee M. Sanders, Smita Bhatia, Lisa J. Chamberlain
beschreibung BACKGROUND Studies of adolescent and young adult (AYA) oncology end-of-life care utilization are critical because cancer is the leading cause of nonaccidental AYA death and end-of-life care contributes significantly to health care expenditures. This study was designed to determine the quantity of and disparities in inpatient utilization in the last year of life of AYAs with cancer. METHODS The California Office of Statewide Health Planning and Development administrative discharge database, linked to death certificates, was used to perform a population-based analysis of cancer patients aged 15 to 39 years who died in 2000-2011. The number of hospital days and the inpatient costs were determined for each patient in the last year of his or her life, as were clinical and sociodemographic factors associated with high inpatient utilization. Admission patterns as death approached were also evaluated. RESULTS The 12,883 patients were admitted for 40 days on average in the last year of life, and this cost $151,072 per patient in inpatient costs. As death approached, the admission rates and the percentage of all admissions occurring at nonspecialty centers increased. Five percent of patients used 20% of bed days in the last year (high utilizers). Factors associated with high utilization included younger age (15-30 years), Hispanic ethnicity, non–health maintenance organization insurance, and hematologic malignancies. CONCLUSIONS AYA oncology decedents were admitted for 40 days in their last year of life. Subgroups with high utilization had distinct sociodemographic and clinical characteristics, and nonspecialty center admissions increased as death approached. This demonstrates the need for palliative care at nonspecialty centers. Future studies need to determine whether these patterns are goal-concurrent, include high utilizers, and monitor the effects of health care reform. Cancer 2018 . © 2018 American Cancer Society .
citation_standardnr 6152992
datenlieferant ipn_articles
feed_copyright The American Cancer Society
feed_copyright_url http://www.cancer.org/
feed_id 424
feed_publisher Wiley-Blackwell
feed_publisher_url http://www.wiley.com/wiley-blackwell
insertion_date 2018-02-03
journaleissn 1097-0142
journalissn 0008-543X
publikationsjahr_anzeige 2018
publikationsjahr_facette 2018
publikationsjahr_intervall 7984:2015-2019
publikationsjahr_sort 2018
publisher Wiley-Blackwell
quelle Cancer
relation http://onlinelibrary.wiley.com/resolve/doi?DOI=10.1002%2Fcncr.31233
search_space articles
shingle_author_1 Emily E. Johnston, Elysia Alvarez, Olga Saynina, Lee M. Sanders, Smita Bhatia, Lisa J. Chamberlain
shingle_author_2 Emily E. Johnston, Elysia Alvarez, Olga Saynina, Lee M. Sanders, Smita Bhatia, Lisa J. Chamberlain
shingle_author_3 Emily E. Johnston, Elysia Alvarez, Olga Saynina, Lee M. Sanders, Smita Bhatia, Lisa J. Chamberlain
shingle_author_4 Emily E. Johnston, Elysia Alvarez, Olga Saynina, Lee M. Sanders, Smita Bhatia, Lisa J. Chamberlain
shingle_catch_all_1 Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California
BACKGROUND Studies of adolescent and young adult (AYA) oncology end-of-life care utilization are critical because cancer is the leading cause of nonaccidental AYA death and end-of-life care contributes significantly to health care expenditures. This study was designed to determine the quantity of and disparities in inpatient utilization in the last year of life of AYAs with cancer. METHODS The California Office of Statewide Health Planning and Development administrative discharge database, linked to death certificates, was used to perform a population-based analysis of cancer patients aged 15 to 39 years who died in 2000-2011. The number of hospital days and the inpatient costs were determined for each patient in the last year of his or her life, as were clinical and sociodemographic factors associated with high inpatient utilization. Admission patterns as death approached were also evaluated. RESULTS The 12,883 patients were admitted for 40 days on average in the last year of life, and this cost $151,072 per patient in inpatient costs. As death approached, the admission rates and the percentage of all admissions occurring at nonspecialty centers increased. Five percent of patients used 20% of bed days in the last year (high utilizers). Factors associated with high utilization included younger age (15-30 years), Hispanic ethnicity, non–health maintenance organization insurance, and hematologic malignancies. CONCLUSIONS AYA oncology decedents were admitted for 40 days in their last year of life. Subgroups with high utilization had distinct sociodemographic and clinical characteristics, and nonspecialty center admissions increased as death approached. This demonstrates the need for palliative care at nonspecialty centers. Future studies need to determine whether these patterns are goal-concurrent, include high utilizers, and monitor the effects of health care reform. Cancer 2018 . © 2018 American Cancer Society .
Emily E. Johnston, Elysia Alvarez, Olga Saynina, Lee M. Sanders, Smita Bhatia, Lisa J. Chamberlain
Wiley-Blackwell
0008-543X
0008543X
1097-0142
10970142
shingle_catch_all_2 Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California
BACKGROUND Studies of adolescent and young adult (AYA) oncology end-of-life care utilization are critical because cancer is the leading cause of nonaccidental AYA death and end-of-life care contributes significantly to health care expenditures. This study was designed to determine the quantity of and disparities in inpatient utilization in the last year of life of AYAs with cancer. METHODS The California Office of Statewide Health Planning and Development administrative discharge database, linked to death certificates, was used to perform a population-based analysis of cancer patients aged 15 to 39 years who died in 2000-2011. The number of hospital days and the inpatient costs were determined for each patient in the last year of his or her life, as were clinical and sociodemographic factors associated with high inpatient utilization. Admission patterns as death approached were also evaluated. RESULTS The 12,883 patients were admitted for 40 days on average in the last year of life, and this cost $151,072 per patient in inpatient costs. As death approached, the admission rates and the percentage of all admissions occurring at nonspecialty centers increased. Five percent of patients used 20% of bed days in the last year (high utilizers). Factors associated with high utilization included younger age (15-30 years), Hispanic ethnicity, non–health maintenance organization insurance, and hematologic malignancies. CONCLUSIONS AYA oncology decedents were admitted for 40 days in their last year of life. Subgroups with high utilization had distinct sociodemographic and clinical characteristics, and nonspecialty center admissions increased as death approached. This demonstrates the need for palliative care at nonspecialty centers. Future studies need to determine whether these patterns are goal-concurrent, include high utilizers, and monitor the effects of health care reform. Cancer 2018 . © 2018 American Cancer Society .
Emily E. Johnston, Elysia Alvarez, Olga Saynina, Lee M. Sanders, Smita Bhatia, Lisa J. Chamberlain
Wiley-Blackwell
0008-543X
0008543X
1097-0142
10970142
shingle_catch_all_3 Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California
BACKGROUND Studies of adolescent and young adult (AYA) oncology end-of-life care utilization are critical because cancer is the leading cause of nonaccidental AYA death and end-of-life care contributes significantly to health care expenditures. This study was designed to determine the quantity of and disparities in inpatient utilization in the last year of life of AYAs with cancer. METHODS The California Office of Statewide Health Planning and Development administrative discharge database, linked to death certificates, was used to perform a population-based analysis of cancer patients aged 15 to 39 years who died in 2000-2011. The number of hospital days and the inpatient costs were determined for each patient in the last year of his or her life, as were clinical and sociodemographic factors associated with high inpatient utilization. Admission patterns as death approached were also evaluated. RESULTS The 12,883 patients were admitted for 40 days on average in the last year of life, and this cost $151,072 per patient in inpatient costs. As death approached, the admission rates and the percentage of all admissions occurring at nonspecialty centers increased. Five percent of patients used 20% of bed days in the last year (high utilizers). Factors associated with high utilization included younger age (15-30 years), Hispanic ethnicity, non–health maintenance organization insurance, and hematologic malignancies. CONCLUSIONS AYA oncology decedents were admitted for 40 days in their last year of life. Subgroups with high utilization had distinct sociodemographic and clinical characteristics, and nonspecialty center admissions increased as death approached. This demonstrates the need for palliative care at nonspecialty centers. Future studies need to determine whether these patterns are goal-concurrent, include high utilizers, and monitor the effects of health care reform. Cancer 2018 . © 2018 American Cancer Society .
Emily E. Johnston, Elysia Alvarez, Olga Saynina, Lee M. Sanders, Smita Bhatia, Lisa J. Chamberlain
Wiley-Blackwell
0008-543X
0008543X
1097-0142
10970142
shingle_catch_all_4 Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California
BACKGROUND Studies of adolescent and young adult (AYA) oncology end-of-life care utilization are critical because cancer is the leading cause of nonaccidental AYA death and end-of-life care contributes significantly to health care expenditures. This study was designed to determine the quantity of and disparities in inpatient utilization in the last year of life of AYAs with cancer. METHODS The California Office of Statewide Health Planning and Development administrative discharge database, linked to death certificates, was used to perform a population-based analysis of cancer patients aged 15 to 39 years who died in 2000-2011. The number of hospital days and the inpatient costs were determined for each patient in the last year of his or her life, as were clinical and sociodemographic factors associated with high inpatient utilization. Admission patterns as death approached were also evaluated. RESULTS The 12,883 patients were admitted for 40 days on average in the last year of life, and this cost $151,072 per patient in inpatient costs. As death approached, the admission rates and the percentage of all admissions occurring at nonspecialty centers increased. Five percent of patients used 20% of bed days in the last year (high utilizers). Factors associated with high utilization included younger age (15-30 years), Hispanic ethnicity, non–health maintenance organization insurance, and hematologic malignancies. CONCLUSIONS AYA oncology decedents were admitted for 40 days in their last year of life. Subgroups with high utilization had distinct sociodemographic and clinical characteristics, and nonspecialty center admissions increased as death approached. This demonstrates the need for palliative care at nonspecialty centers. Future studies need to determine whether these patterns are goal-concurrent, include high utilizers, and monitor the effects of health care reform. Cancer 2018 . © 2018 American Cancer Society .
Emily E. Johnston, Elysia Alvarez, Olga Saynina, Lee M. Sanders, Smita Bhatia, Lisa J. Chamberlain
Wiley-Blackwell
0008-543X
0008543X
1097-0142
10970142
shingle_title_1 Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California
shingle_title_2 Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California
shingle_title_3 Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California
shingle_title_4 Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California
timestamp 2025-06-30T23:32:24.352Z
titel Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California
titel_suche Inpatient utilization and disparities: The last year of life of adolescent and young adult oncology patients in California
topic W
WW-YZ
uid ipn_articles_6152992