Background
How this fits in
(1) Rapid increase in patient’s health care utilization in relation to proximity of death and of severe illness is well known. (2) On basis of German electronic patient records (EPR), we confirmed increased patient contact frequencies in primary care before a first malignancy diagnosis was made. This tendency started already several quarters before the diagnosis. However, the effect size of this trend was very small so that we cannot recommend any specific action for GPs from this. (3) Elaborated data analysis was needed for validation of results and for any specific recommendations |
Method
Study design
Patients
Calculation of contact frequencies
Statistical analysis
Results
The sample
Contact frequencies
Changes in inter-contact intervals (ICI)
Analysis of variance in contact frequencies
Source | df | Mean square | F statistic | Pr > F |
---|---|---|---|---|
Model | 4 | 3.83 | 27.91 | < 0.0001 |
Error | 9,377 | 0.14 | ||
Gender | 1 | 0.07 | 0.50 | 0.4773 |
Case/control | 1 | 14.08 | 102.55 | < 0.0001 |
Quarter | 1 | 0.30 | 2.21 | 0.1376 |
Case/control*Quarter | 1 | 0.43 | 3.12 | 0.0775 |
Analysis of contact frequencies over six quarters as repeated measures
Source | df | Mean square | F statistic | Pr > F |
---|---|---|---|---|
Model | 4 | 3.24 | 24.19 | < 0,0001 |
Error | 7,852 | 0.31 | ||
Gender | 1 | 0.10 | 0.77 | 0,3787 |
Case/control | 1 | 7.95 | 59.32 | < 0,0001 |
Quarter | 1 | 0.86 | 6.38 | 0,0115 |
Case/control*Quarter | 1 | 1.20 | 8.95 | 0,0028 |
Source | df | Mean square | F statistic | Pr > F |
---|---|---|---|---|
Gender | 1 | 0.01 | 0.00 | 0.9903 |
Case/control | 1 | 608.1 | 8.39 | 0.0038 |
Gender*Case/control | 1 | 103.09 | 1.42 | 0.2335 |
Error (contacts) | 1,684 | 72.57 |
Source | df | Mean square | F statistic | Pr > F |
---|---|---|---|---|
Contacts | 5 | 102.23 | 12.72 | < 0.0001 |
Contacts*Gender | 5 | 4.75 | 0.59 | 0.7067 |
Contacts*Case/control | 5 | 19.15 | 2.38 | 0.0361 |
Contacts*Gender*Case/control | 5 | 12.06 | 1.5 | 0.1861 |
Error (contacts) | 8,420 | 8.04 |