A person-time analysis of hospital activity among cancer survivors in England

Abstract

Background:There are around 2 million cancer survivors in the UK. This study describes the inpatient and day case hospital activity among the population of cancer survivors in England. This is one measure of the burden of cancer on the individual and the health service.Methods:The national cancer registry data set for England (1990–2006) is linked to the NHS Hospital Episode Statistics (HES) database. Cohorts of survivors were defined as those people recorded in the cancer registry data with a diagnosis of breast, colorectal, lung or prostate cancer before 2007. The person-time of prevalence in 2006 for each cohort of survivors was calculated according to the cancer type, sex, age and time since diagnosis. The corresponding HES episodes of care in 2006 were used to calculate the person-time of admitted hospital care for each cohort of survivors. The average proportion of time spent in hospital by survivors in each cohort was calculated as the summed person-time of hospital activity divided by the summed person-time of prevalence. The analysis was conducted separately for cancer-related episodes and non-cancer-related episodes.Results:Lung cancer survivors had the highest intensity of cancer-related hospital activity. For all cancers, cancer-related hospital activity was highest in the first year following diagnosis. Breast and prostate cancer survivors had peaks of cancer-related hospital activity in the relatively young and relatively old age groups. The proportion of time spent in hospital for non-cancer-related care was much lower than that for cancer-related care and increased gradually with age but was generally constant regardless of time since diagnosis.Conclusion:The person-time approach used in this study is more revealing than a simple enumeration of cancer survivors and hospital admissions. Hospital activity among cancer survivors is highest soon after diagnosis. The effect of age on the amount of hospital activity is different for each type of cancer.

Health care services use among long-term breast cancer survivors: a systematic review

“…The range of reported survival periods differed among all the studies, even though all of them included survival of at least 5 years or more. Lu et al [39] included the longest follow-up period (16 years from diagnosis), followed by the studies by Maddams et al [40] and Weaver et al [49] with 16 and 14 years of follow-up, respectively.…”

Hospital admissions in children with cerebral palsy: a data linkage study

“…[11][12][13] Roder et al 14 describe the role of the cancer register in this type of research as 'the data spine', around which data from other sources are linked to demonstrate patterns of service use in this population. [11][12][13] Roder et al 14 describe the role of the cancer register in this type of research as 'the data spine', around which data from other sources are linked to demonstrate patterns of service use in this population.…”

“…In recent years, the ability of disease registers to inform health service management and evaluation through linkage with other data sets has been recognized, and internationally, cancer registries have been used extensively to investigate morbidity and health service use in this patient group. [11][12][13] Roder et al 14 describe the role of the cancer register in this type of research as 'the data spine', around which data from other sources are linked to demonstrate patterns of service use in this population. Geographically-defined CP registers are well placed to play such a role in investigating the health service needs of individuals with CP.…”

The evolution of cancer registration

“…As Roder et al show in this issue, and has been shown elsewhere in the world, cancer registry data when combined with other administrative or clinical datasets provides the starting point for a variety of different analyses (Maddams et al . ; Mittmann et al . ; Sharpe et al .…”

“…As Roder et al show in this issue, and has been shown elsewhere in the world, cancer registry data when combined with other administrative or clinical datasets Correspondence address: Jem Rashbass, Disease Registration, Public Health England, 5th Floor, Wellington House, 133-155 Waterloo Road, London SE1 8UG, UK (e-mail: jem.rashbass@phe.gov.uk). provides the starting point for a variety of different analyses (Maddams et al 2011;Mittmann et al 2014;Sharpe et al 2014).…”