Tullika Garg1, Amanda J Young2, Korey A Kost3, John F Danella4, Sharon Larson5, Matthew E Nielsen6, H Lester Kirchner7. 1. Department of Urology, Geisinger Health System, Danville, Pennsylvania; Department of Health Services Research and Epidemiology, Geisinger Health System, Danville, Pennsylvania. Electronic address: tgarg@geisinger.edu. 2. Biostatistics Core, Geisinger Health System, Danville, Pennsylvania. 3. Phenomic Analytics and Clinical Data Core, Geisinger Health System, Danville, Pennsylvania. 4. Department of Urology, Geisinger Health System, Danville, Pennsylvania. 5. Department of Health Services Research and Epidemiology, Geisinger Health System, Danville, Pennsylvania. 6. Department of Urology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina. 7. Biomedical and Translational Informatics Institute, Geisinger Health System, Danville, Pennsylvania.
Abstract
PURPOSE: We describe age, multiple chronic condition profiles and health system contact in patients with urological cancer. MATERIALS AND METHODS: Using Geisinger Health System electronic health records we identified adult primary care patients and a subset with at least 1 urology encounter between 2001 and 2015. The Agency for Health Care Research and Quality Chronic Condition Indicator and Clinical Classifications Software tools were applied to ICD-9 codes to identify chronic conditions. Multiple chronic conditions were defined as 2 or more chronic conditions. Patients with urological cancer were identified using ICD-9 codes for prostate, bladder, kidney, testis and penile cancer. Inpatient and outpatient visits in the year prior to the most recent encounter were counted to document health system contact. RESULTS: We identified 357,100 primary care and 33,079 urology patients, of whom 4,023 had urological cancer. Patients with urological cancer were older than primary care patients (71 vs 46 years) and they had more median chronic conditions (7 vs 4). Kidney and bladder cancer were the most common chronic conditions (median 8 patients each). Coronary artery disease and chronic kidney disease were common in urological cancer cases compared to mental health conditions in primary care cases. Patients with urological cancer who had multiple chronic conditions had the most health system contact, including 32% with at least 1 hospitalization and 68% with more than 5 outpatient visits during 1 year. CONCLUSIONS: Urology patients are older and more medically complex, especially those with urological cancer than primary care patients. These data may inform care redesign to reduce the treatment burden and improve care coordination in urological cancer cases.
PURPOSE: We describe age, multiple chronic condition profiles and health system contact in patients with urological cancer. MATERIALS AND METHODS: Using Geisinger Health System electronic health records we identified adult primary care patients and a subset with at least 1 urology encounter between 2001 and 2015. The Agency for Health Care Research and Quality Chronic Condition Indicator and Clinical Classifications Software tools were applied to ICD-9 codes to identify chronic conditions. Multiple chronic conditions were defined as 2 or more chronic conditions. Patients with urological cancer were identified using ICD-9 codes for prostate, bladder, kidney, testis and penile cancer. Inpatient and outpatient visits in the year prior to the most recent encounter were counted to document health system contact. RESULTS: We identified 357,100 primary care and 33,079 urology patients, of whom 4,023 had urological cancer. Patients with urological cancer were older than primary care patients (71 vs 46 years) and they had more median chronic conditions (7 vs 4). Kidney and bladder cancer were the most common chronic conditions (median 8 patients each). Coronary artery disease and chronic kidney disease were common in urological cancer cases compared to mental health conditions in primary care cases. Patients with urological cancer who had multiple chronic conditions had the most health system contact, including 32% with at least 1 hospitalization and 68% with more than 5 outpatient visits during 1 year. CONCLUSIONS: Urology patients are older and more medically complex, especially those with urological cancer than primary care patients. These data may inform care redesign to reduce the treatment burden and improve care coordination in urological cancer cases.
Authors: Danyon Anderson; Abrahim N Razzak; Matthew McDonald; David Cao; Jamal Hasoon; Omar Viswanath; Alan D Kaye; Ivan Urits Journal: Health Psychol Res Date: 2022-08-20
Authors: Ashkan Mortezavi; Alessio Crippa; Sebastian Edeling; Sasa Pokupic; Paolo Dell'Oglio; Francesco Montorsi; Frederiek D'Hondt; Alexandre Mottrie; Karel Decaestecker; Carl J Wijburg; Justin Collins; John D Kelly; Wei Shen Tan; Ashwin Sridhar; Hubert John; Abdullah Erdem Canda; Christian Schwentner; Erik Peder Rönmark; Peter Wiklund; Abolfazl Hosseini Journal: BJU Int Date: 2020-11-05 Impact factor: 5.588
Authors: Tullika Garg; Amanda J Young; Maureen O'Keeffe-Rosetti; Carmit K McMullen; Matthew E Nielsen; H Lester Kirchner; Terrence E Murphy Journal: Cancer Date: 2018-10-05 Impact factor: 6.921