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Cancer patients ’ use of primary care out-of-hours services: a cross-sectional study in Norway

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To investigate how cancer patients in Norway use primary care out-of-hours (OOH) services and describe different contact types and procedures.

Design: A retrospective cross-sectional registry study using a billing registry data source.

Setting: Norwegian primary care OOH services in 2014.

Subjects: All patients’ contacts in OOH services in 2014. Cancer patients were identified by ICPC-2 diagnosis.

Main outcome measures: Frequency of cancer patients’ contacts with OOH services, contact types, diagnoses, procedures, and socio-demographic characteristics.

Results: In total, 5752 cancer patients had 20,220 contacts (1% of all) in OOH services. Half of the contacts were cancer related. Cancer in the digestive (22.9%) and respiratory (18.0%) systems were most frequent; and infection/fever (21.8%) and pain (13.6%) most frequent additional diagnoses. A total of 4170 patients had at least one cancer-related direct contact; of these, 64.5% had only one contact during the year. Cancer patients had more home visits and more physicians’ contact with municipal nursing services than other patients, but fewer consultations (p < 0.001). Patients in the least central municipalities had significantly more contacts than more central municipalities (p < 0.001).

Conclusion: There was no indication of overuse of OOH services by cancer patients in Norway, which could indicate good quality of cancer care in general.

Key points:   Many are concerned about unnecessary use of emergency medical services for non-urgent conditions.

Key points: • There was no indication of overuse of out-of-hours services by cancer patients in Norway.

Key points: • Cancer patients had relatively more home visits, physician’s contact with the municipal nursing service, and weekend contacts than other patients.

Key points: • Cancer patients in the least central municipalities had relatively more contacts with out-of-hours services than those in more central municipalities.

Key points: • Cancer patients in the least central municipalities had relatively more contacts with out-of-hours services than those in more central municipalities.

No MeSH data available.


Related in: MedlinePlus

Flowchart of contacts for cancer patients in contact with out-of-hours services (consultation, home visit, simple, telephone or nursing service) in 2014.
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Figure 0001: Flowchart of contacts for cancer patients in contact with out-of-hours services (consultation, home visit, simple, telephone or nursing service) in 2014.

Mentions: All contacts identified by electronic billing claims in OOH services in 2014 were included (Figure 1). Paper-based claims, < 1%, were not included. We identified cancer patients with at least one OOH contact during 2014 by identifying billing claims holding a cancer diagnosis, according to the International Classification of Primary Care (ICPC-2).[17] One billing claim was defined as one contact. We also included ‘contacts with other diagnoses’ for these patients, identified by pseudo ID. These contacts did not hold a cancer diagnosis and thus could not be identified as cancer related with certainty. Contacts with missing pseudo ID (n = 36) and without one of the below classified contact types (n = 36) were excluded.


Cancer patients ’ use of primary care out-of-hours services: a cross-sectional study in Norway
Flowchart of contacts for cancer patients in contact with out-of-hours services (consultation, home visit, simple, telephone or nursing service) in 2014.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036012&req=5

Figure 0001: Flowchart of contacts for cancer patients in contact with out-of-hours services (consultation, home visit, simple, telephone or nursing service) in 2014.
Mentions: All contacts identified by electronic billing claims in OOH services in 2014 were included (Figure 1). Paper-based claims, < 1%, were not included. We identified cancer patients with at least one OOH contact during 2014 by identifying billing claims holding a cancer diagnosis, according to the International Classification of Primary Care (ICPC-2).[17] One billing claim was defined as one contact. We also included ‘contacts with other diagnoses’ for these patients, identified by pseudo ID. These contacts did not hold a cancer diagnosis and thus could not be identified as cancer related with certainty. Contacts with missing pseudo ID (n = 36) and without one of the below classified contact types (n = 36) were excluded.

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To investigate how cancer patients in Norway use primary care out-of-hours (OOH) services and describe different contact types and procedures.

Design: A retrospective cross-sectional registry study using a billing registry data source.

Setting: Norwegian primary care OOH services in 2014.

Subjects: All patients&rsquo; contacts in OOH services in 2014. Cancer patients were identified by ICPC-2 diagnosis.

Main outcome measures: Frequency of cancer patients&rsquo; contacts with OOH services, contact types, diagnoses, procedures, and socio-demographic characteristics.

Results: In total, 5752 cancer patients had 20,220 contacts (1% of all) in OOH services. Half of the contacts were cancer related. Cancer in the digestive (22.9%) and respiratory (18.0%) systems were most frequent; and infection/fever (21.8%) and pain (13.6%) most frequent additional diagnoses. A total of 4170 patients had at least one cancer-related direct contact; of these, 64.5% had only one contact during the year. Cancer patients had more home visits and more physicians&rsquo; contact with municipal nursing services than other patients, but fewer consultations (p&thinsp;&lt;&thinsp;0.001). Patients in the least central municipalities had significantly more contacts than more central municipalities (p&thinsp;&lt;&thinsp;0.001).

Conclusion: There was no indication of overuse of OOH services by cancer patients in Norway, which could indicate good quality of cancer care in general.

Key points: &emsp;&ensp;Many are concerned about unnecessary use of emergency medical services for non-urgent conditions.

Key points: &bull;&emsp;There was no indication of overuse of out-of-hours services by cancer patients in Norway.

Key points: &bull;&emsp;Cancer patients had relatively more home visits, physician&rsquo;s contact with the municipal nursing service, and weekend contacts than other patients.

Key points: &bull;&emsp;Cancer patients in the least central municipalities had relatively more contacts with out-of-hours services than those in more central municipalities.

Key points: &bull;&emsp;Cancer patients in the least central municipalities had relatively more contacts with out-of-hours services than those in more central municipalities.

No MeSH data available.


Related in: MedlinePlus