Use of CT, ED presentation and hospitalisations 12 months before and after a diagnosis of cancer in Western Australia: a population-based retrospective cohort study
Rachael Moorin,
Max K Bulsara,
Jenny Doust,
David Youens,
Ninh Thi Ha,
Donald Mcrobbie,
Peter O’Leary,
Richard Trevithick,
Cameron Wright,
Sviatlana Kamarova,
Chau Ho
Affiliations
Rachael Moorin
School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
Max K Bulsara
Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
Jenny Doust
Australian Women and Girls` Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
David Youens
Centre for Health Services Research, School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
Ninh Thi Ha
School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
Donald Mcrobbie
School of Physical Sciences, University of Adelaide, Adelaide, South Australia, Australia
Peter O’Leary
School of Population Health, Curtin University, Perth, Western Australia, Australia
Richard Trevithick
Western Australian Cancer Registry, Clinical Excellence Division, Department of Health, East Perth, Western Australia, Australia
Cameron Wright
School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
Sviatlana Kamarova
School of Population Health, Curtin University, Perth, Western Australia, Australia
Chau Ho
School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
Objective To examine the use of CT, emergency department (ED)-presentation and hospitalisation and in 12 months before and after a diagnosis of cancer.Design Population-based retrospective cohort study.Setting West Australian linked administrative records at individual level.Participants 104 009 adults newly diagnosed with cancer in 2004–2014.Main outcome measures CT use, ED presentations, hospitalisations.Results As compared with the rates in the 12th month before diagnosis, the rate of CT scans started to increase from 2 months before diagnosis with an increase in both ED presentations and hospitalisation from 1 month before the diagnosis. These rates peaked in the month of diagnosis for CT scans (477 (95% CI 471 to 482) per 1000 patients), and for hospitalisations (910 (95% CI 902 to 919) per 1000 patients), and the month prior to diagnosis for ED (181 (95% CI 178 to 184) per 1000 patients) then rapidly reduced after diagnosis but remained high for the next 12 months. While the patterns of the health services used were similar between 2004 and 2014, the rate of the health services used during after diagnosis was higher in 2014 versus 2004 except for CT use in patients with lymphohaematopoietic cancer with a significant reduction.Conclusion Our results showed an increase in demand for health services from 2 months before diagnosis of cancer. Increasing use of health services during and post cancer diagnosis may warrant further investigation to identify factors driving this change.
