TY - JOUR
T1 - Predictors of unplanned hospitalizations in patients with nonmetastatic lung cancer during chemotherapy
AU - Fessele, Kristen L.
AU - Hayat, Matthew J.
AU - Atkins, Robert L.
N1 - Publisher Copyright:
© 2017 by the Oncology Nursing Society.
PY - 2017/9
Y1 - 2017/9
N2 - Purpose/Objectives: To determine predictors of unplanned hospitalizations in patients with lung cancer to receive chemotherapy in the outpatient setting and examine the potential financial burden of these events. Design: Retrospective, longitudinal cohort study. Setting: The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Sample: Of 104,388 incident cases of lung cancer diagnosed from 2005-2009, 2,457 cases of patients with lung cancer who received outpatient chemotherapy were identified. Patients were aged 66 years or older at diagnosis, had uninterrupted Medicare Part A and B coverage with no health maintenance organization enrollment, and received IV chemotherapy at least once. Methods: Generalized estimating equations was used. Main Research Variables: Patient age, sex, race, marital status, degree of residential urbanization, median income, education level, stage, receipt of radiation therapy, and comorbidities. Findings: Younger age, non-White race, lower education, higher income, receipt of radiation therapy, and lack of preexisting comorbidity were significant predictors of the likelihood of an initial unplanned hospitalization for lung cancer. Non-White race, receipt of radiation therapy, and comorbidity were factors associated with an increased number of hospitalizations. Conclusions: Unplanned hospitalizations are frequent, disruptive, and costly. This article defines areas for further exploration to identify patients at high risk for unexpected complications. Implications for Nursing: This article represents a foundation for development of risk models to enable nursing evaluation of patient risk for chemotherapy treatment interruption and unplanned hospitalization.
AB - Purpose/Objectives: To determine predictors of unplanned hospitalizations in patients with lung cancer to receive chemotherapy in the outpatient setting and examine the potential financial burden of these events. Design: Retrospective, longitudinal cohort study. Setting: The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Sample: Of 104,388 incident cases of lung cancer diagnosed from 2005-2009, 2,457 cases of patients with lung cancer who received outpatient chemotherapy were identified. Patients were aged 66 years or older at diagnosis, had uninterrupted Medicare Part A and B coverage with no health maintenance organization enrollment, and received IV chemotherapy at least once. Methods: Generalized estimating equations was used. Main Research Variables: Patient age, sex, race, marital status, degree of residential urbanization, median income, education level, stage, receipt of radiation therapy, and comorbidities. Findings: Younger age, non-White race, lower education, higher income, receipt of radiation therapy, and lack of preexisting comorbidity were significant predictors of the likelihood of an initial unplanned hospitalization for lung cancer. Non-White race, receipt of radiation therapy, and comorbidity were factors associated with an increased number of hospitalizations. Conclusions: Unplanned hospitalizations are frequent, disruptive, and costly. This article defines areas for further exploration to identify patients at high risk for unexpected complications. Implications for Nursing: This article represents a foundation for development of risk models to enable nursing evaluation of patient risk for chemotherapy treatment interruption and unplanned hospitalization.
KW - Chemotherapy
KW - Comorbidity
KW - Hospitalization
KW - Lung neoplasms
KW - SEER-medicare
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U2 - 10.1188/17.ONF.E203-E212
DO - 10.1188/17.ONF.E203-E212
M3 - Article
C2 - 28820513
AN - SCOPUS:85028304629
SN - 0190-535X
VL - 44
SP - E203-E212
JO - Oncology nursing forum
JF - Oncology nursing forum
IS - 5
ER -