Anna Jansana1,2,3, Laia Domingo1,3, Berta Ibañez3,4, Alexandra Prados3,5, Isabel Del Cura3,6,7, Maria Padilla-Ruiz3,8, Teresa Sanz3,6, Beatriz Poblador3,5, Ibai Tamayo3,4, Antonio Gimeno3,4, Angel Alberquilla3,6, Mercè Abizanda9, Mercè Comas1,3, Manuela Lanzuela10, Rossana Burgui11, Antonio Diaz Holgado12, Talita Duarte-Salles13, Conchi Moreno3,11, Javier Louro1,3, Javier Baquedano3,14, Cristobal Molina8, Maria Del Carmen Martinez8, Javier Gorricho3,15, Maximino Redondo8, Xavier Castells1,3,16, Maria Sala17,18. 1. Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, 08003, Barcelona, Spain. 2. European Higher Education Area Doctoral Program in Methodology of Biomedical Research and Public Health in Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine and Public Health, Universitat Autónoma de Barcelona (UAB), Bellaterra, Barcelona, Spain. 3. Health Services Research on Chronic Patients Network (REDISSEC), Institute of Health Carlos III, Madrid, Spain. 4. Navarrabiomed-Complejo Hospitalario de Navarra-Universidad Pública de Navarra, IdiSNA, Irunlarrea, s/n, 31008, Pamplona, Spain. 5. IIS Aragon, Miguel Servet University Hospital, EpiChron Research Group, Aragon Health Sciences Institute (IACS), Zaragoza, Spain. 6. Madrid Health Service, Primary Care Research Unit, Calle San Martín de Porres, 6-5ª planta, 28035, Madrid, Spain. 7. Department of Preventive Medicine and Public Health, University Rey Juan Carlos, Avenida de Atenas, 28922, Alcorcón, Madrid, Spain. 8. Research Unit, Costa del Sol Hospital, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Marbella, Spain. 9. Department of Organization and Communication, Parc Sanitari Pere Virgili, Barcelona, Spain. 10. Radiotherapy Department, Miguel Servet University Hospital, Saragossa, Spain. 11. Instituto de Salud Pública y Laboral de Navarra (ISPLN), IdiSNA, Pamplona, Spain. 12. Madrid Health Service, Technical Direction of Sanitary Information System, Calle San Martín de Porres, 6- 5ª planta, 28035, Madrid, Spain. 13. Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain. 14. Servicio Navarro de Salud-Osasunbidea, Gerencia de Atención Primaria, Pamplona, Spain. 15. Servicio de Evaluación y Difusión de resultados en Salud, Servicio Navarro de Salud-Osasunbidea, Pamplona, Spain. 16. Autonomous University of Barcelona (UAB), 08193, Bellaterra, Barcelona, Spain. 17. Department of Epidemiology and Evaluation, IMIM (Hospital del Mar Medical Research Institute), Passeig Marítim, 25-29, 08003, Barcelona, Spain. msalaserra@parcdesalutmar.cat. 18. Health Services Research on Chronic Patients Network (REDISSEC), Institute of Health Carlos III, Madrid, Spain. msalaserra@parcdesalutmar.cat.
Abstract
PURPOSE: This study aimed to evaluate health service utilization in Spain among long-term breast cancer survivors and to compare it with that among women with no history of breast cancer. METHODS: Study based on the SURBCAN cohort includes a sample of long-term breast cancer survivors and a sample of women without breast cancer from 5 Spanish regions. Healthcare utilization was assessed through primary care, hospital visits, and tests during the follow-up period (2012 to 2016) by using electronic health records. Annual contact rates to healthcare services were calculated, and crude and multivariate count models were fitted to estimate the adjusted relative risk of healthcare services use. RESULTS: Data were obtained from 19,328 women, including 6512 long-term breast cancer survivors. Healthcare use was higher among breast cancer survivors (20.9 vs 16.6; p < 0.0001) and decreased from >10 years of survival. Breast cancer survivors who underwent a mastectomy were more likely to have a primary care visit (RR = 3.10 95% CI 3.08-3.11). Five to ten years survivors were more likely to have hospital inpatient visits and imaging test compared to women without breast cancer (RRa = 1.35 95% CI 1.30-1.39 and RRa = 1.27 95% CI 1.25-1.29 respectively). CONCLUSION: This study shows higher use of health services in long-term breast cancer survivors than in women without breast cancer regardless of survival time. IMPLICATIONS FOR CANCER SURVIVORS: These results help to estimate the health resources needed for the growing group of breast cancer survivors and to identify risk factors that drive higher use of health services.
PURPOSE: This study aimed to evaluate health service utilization in Spain among long-term breast cancer survivors and to compare it with that among women with no history of breast cancer. METHODS: Study based on the SURBCAN cohort includes a sample of long-term breast cancer survivors and a sample of women without breast cancer from 5 Spanish regions. Healthcare utilization was assessed through primary care, hospital visits, and tests during the follow-up period (2012 to 2016) by using electronic health records. Annual contact rates to healthcare services were calculated, and crude and multivariate count models were fitted to estimate the adjusted relative risk of healthcare services use. RESULTS: Data were obtained from 19,328 women, including 6512 long-term breast cancer survivors. Healthcare use was higher among breast cancer survivors (20.9 vs 16.6; p < 0.0001) and decreased from >10 years of survival. Breast cancer survivors who underwent a mastectomy were more likely to have a primary care visit (RR = 3.10 95% CI 3.08-3.11). Five to ten years survivors were more likely to have hospital inpatient visits and imaging test compared to women without breast cancer (RRa = 1.35 95% CI 1.30-1.39 and RRa = 1.27 95% CI 1.25-1.29 respectively). CONCLUSION: This study shows higher use of health services in long-term breast cancer survivors than in women without breast cancer regardless of survival time. IMPLICATIONS FOR CANCER SURVIVORS: These results help to estimate the health resources needed for the growing group of breast cancer survivors and to identify risk factors that drive higher use of health services.
Authors: C Kendell; K M Decker; P A Groome; M L McBride; L Jiang; M K Krzyzanowska; G Porter; D Turner; R Urquhart; M Winget; E Grunfeld Journal: Curr Oncol Date: 2017-04-27 Impact factor: 3.677
Authors: Wee Loon Ong; Maartje G Schouwenburg; Annelotte C M van Bommel; Caleb Stowell; Kim H Allison; Karen E Benn; John P Browne; Rodney D Cooter; Geoff P Delaney; Francois P Duhoux; Patricia A Ganz; Patricia Hancock; Reshma Jagsi; Felicia M Knaul; Anne M Knip; Linetta B Koppert; Henry M Kuerer; Sarah McLaughin; Marc A M Mureau; Ann H Partridge; Dereesa Purtell Reid; Lisa Sheeran; Thomas J Smith; Mark J Stoutjesdijk; Marie Jeanne T F D Vrancken Peeters; Yvonne Wengström; Cheng-Har Yip; Christobel Saunders Journal: JAMA Oncol Date: 2017-05-01 Impact factor: 31.777
Authors: B Bouvard; J Chatelais; P Soulié; E Hoppé; P Saulnier; O Capitain; M Mege; N Mesgouez-Nebout; E Jadaud; S Abadie-Lacourtoisie; M Campone; E Legrand Journal: Eur J Cancer Date: 2018-07-20 Impact factor: 9.162
Authors: Ellen B Rubinstein; William L Miller; Shawna V Hudson; Jenna Howard; Denalee O'Malley; Jennifer Tsui; Heather Sophia Lee; Alicja Bator; Benjamin F Crabtree Journal: JAMA Intern Med Date: 2017-12-01 Impact factor: 21.873
Authors: Freddie Bray; Jacques Ferlay; Isabelle Soerjomataram; Rebecca L Siegel; Lindsey A Torre; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2018-09-12 Impact factor: 508.702
Authors: Mary L McBride; Patti A Groome; Kathleen Decker; Cynthia Kendell; Li Jiang; Marlo Whitehead; Dongdong Li; Eva Grunfeld Journal: BMC Cancer Date: 2019-07-04 Impact factor: 4.430
Authors: A Prados-Torres; B Poblador-Plou; A Gimeno-Miguel; A Calderón-Larrañaga; A Poncel-Falcó; L A Gimeno-Feliú; F González-Rubio; C Laguna-Berna; J Marta-Moreno; M Clerencia-Sierra; M Aza-Pascual-Salcedo; A C Bandrés-Liso; C Coscollar-Santaliestra; V Pico-Soler; J M Abad-Díez Journal: Int J Epidemiol Date: 2018-04-01 Impact factor: 7.196
Authors: Anna Jansana; Isabel Del Cura; Alexandra Prados-Torres; Teresa Sanz Cuesta; Beatriz Poblador-Plou; A Gimeno Miguel; Manuela Lanzuela; Berta Ibañez; Ibai Tamayo; Conchi Moreno-Iribas; María Padilla-Ruiz; Maximino Redondo; Mercè Comas; Laia Domingo; Antonio Díaz-Holgado; Francisco Javier Salamanca; Xavier Castells; Maria Sala Journal: BMJ Open Date: 2020-09-09 Impact factor: 2.692