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12.08.2020 | Health Services Research and Global Oncology

Immediate and Long-Term Health Care Support Needs of Older Adults Undergoing Cancer Surgery: A Population-Based Analysis of Postoperative Homecare Utilization

verfasst von: Tyler R. Chesney, MD, MSc, Barbara Haas, MD, PhD, Natalie G. Coburn, MD, MPH, Alyson L. Mahar, PhD, Victoria Zuk, MHSc, Haoyu Zhao, MPH, Amy T. Hsu, PhD, Julie Hallet, MD, MSc, Recovery after Surgical Therapy for Older Adults Research–Cancer (RESTORE-Cancer) Group

Erschienen in: Annals of Surgical Oncology | Ausgabe 3/2021

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Abstract

Background

Functional outcomes are central to decision-making by older adults (OA), but long-term risks after cancer surgery have not been described beyond 1 year for this population. This study aimed to evaluate long-term health care support needs by examining homecare use after cancer surgery for OA.

Methods

This population-based study investigated adults 70 years of age or older with a new cancer diagnosis between 2007 and 2017 who underwent resection. The outcomes were receipt and intensity of homecare from postoperative discharge to 5 years after surgery. Time-to-event analysis with competing events was used.

Results

Among 82,037 patients, homecare use was highest (43.7% of eligible patients) in postoperative month 1. The need for homecare subsequently decreased to stabilize between year 1 (13.9%) and year 5 (12.6%). Of the patients not receiving preoperative homecare, 10.9% became long-term users at year 5 after surgery. Advancing age, female sex, frailty, high-intensity surgery, more recent period of surgery, and receipt of preoperative homecare were associated with increased hazards of postoperative homecare. Intensity of homecare went from 10.3 to 10.1 days per patient-month between month 1 and year 1, reaching 12 days per patient-month at year 5. The type of homecare services changed from predominantly nursing care in year 1 (51.9%) to increasing personal support services from year 2 (69.6%) to year 5 (77.5%).

Conclusion

Receipt of homecare increased long-term after cancer surgery for OA, peaking in the first 6 months and plateauing thereafter at a new baseline. One tenth of the patients without preoperative homecare became long-term homecare users postoperatively, indicating changing health care needs focused on personal support services from year 2 to year 5.

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Titel: Immediate and Long-Term Health Care Support Needs of Older Adults Undergoing Cancer Surgery: A Population-Based Analysis of Postoperative Homecare Utilization
verfasst von: Tyler R. Chesney, MD, MSc
Barbara Haas, MD, PhD
Natalie G. Coburn, MD, MPH
Alyson L. Mahar, PhD
Victoria Zuk, MHSc
Haoyu Zhao, MPH
Amy T. Hsu, PhD
Julie Hallet, MD, MSc
Recovery after Surgical Therapy for Older Adults Research–Cancer (RESTORE-Cancer) Group
Publikationsdatum: 12.08.2020
Verlag: Springer International Publishing
Erschienen in: Annals of Surgical Oncology / Ausgabe 3/2021
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-020-08992-8

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