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ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2024

Is it legitimate to use unplanned hospitalizations as a quality indicator for cancer patients? A retrospective French cohort study with special attention to the influence of social deprivation.

Thomas Vermeulin, Loetizia Froment, Véronique Merle, Brigitte Dormont

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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4 authors.

Thomas VermeulinDepartment of Medical Information, Centre Henri Becquerel, Rouen, France. thomas.vermeulin@chb.unicancer.fr.ORCID https://orcid.org/0000-0003-4744-3135
Loetizia FromentCHU Rouen, Research team "Dynamique et Evénements des Soins et des Parcours", F-76000, Rouen, France.
Véronique MerleCHU Rouen, Research team "Dynamique et Evénements des Soins et des Parcours", F-76000, Rouen, France.
Brigitte DormontParis Dauphine University-PSL, LEDA, CNRS, IRD, LEGOS, Paris, France.

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6 · The paper itself

Abstract

purposeReadmission indicators are used around the world to assess the quality of hospital care. We aimed to assess the relevance of this type of indicator in oncology, especially for socially deprived patients. Our objectives were (1) to assess the proportion of unplanned hospitalizations (UHs) in cancer patients, (2) to assess the proportion of UHs that were avoidable, i.e., related to poor care quality, and (3) to analyze cancer patients the effect of patients' deprivation level on the type of UH (avoidable UHs vs. unavoidable UHs).

methodsIn a French university hospital, we selected all hospitalizations over a year for a random sample of cancer patients. Based on medical records, we identified those among UHs due to avoidable health problems. We assessed the association between social deprivation, home-to-hospital distance, or home-to-general practitioner with the type of UH (avoidable vs. unavoidable) via a multivariate binary logit estimation.

resultsAmong 2349 hospitalizations (355 patients), there were 383 UHs (16 %), among which 38% were avoidable. Among UHs, the European Deprivation Index was significantly associated with the risk of avoidable UHs, with a lower risk of avoidable UH for patients with medium or high social deprivation.

conclusionOur results suggest that the use of UHs rate as a quality indicator is questionable in oncology. Indeed, the majority of UHs were not avoidable. Furthermore, within UHs, those involving patients with medium or high social deprivation are more often unavoidable in comparison with other patients.

Indexed as

HospitalizationNeoplasmsQuality Indicators, Health CareAdultAgedAged, 80 and overCohort StudiesFemaleFranceHospitals, UniversityHumansMaleMiddle AgedPatient ReadmissionQuality of Health CareRetrospective StudiesHealth economicsNeoplasmsPatient readmissionPublic HealthSocial environment

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.