Factors associated with Emergency Admissions for Cancer Patients in Last year of life in a UK region


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Victoria Cairnduff1,Laura Dwyer1,Colin Fox1,Gregory Fallica2,Kelly Shiell-Davis3,Anna Gavin1
1Northern Ireland Cancer Registry, Belfast, UK,2Macmillan Cancer Support,3Macmillan Cancer Support, London, UK

Abstract

Background

Emergency admissions towards end-of-life may indicate gaps in routine cancer care. This project aims to examine the demographic, disease and environmental characteristics of people dying with cancer admitted as an emergency in the last year of life to provide information to improve services.

Method

 Data on all cancer deaths in N.Ireland (NI) in 2015 were linked with hospital episodes relating to emergency admissions in the last year of life. Logistic Regression was carried out using “at least one emergency admission recorded” as the outcome variable. 

Results

Of 4,224 people dying of cancer in NI in 2015, 74.2%; (n=3,134) had at least one emergency admission is the last year of life recorded and 36.6% (n=1,546) in the last 28 days of life. The factors with a significant positive association to having an emergency admission in last year of life (model I) were tumour site, stage at diagnosis, time from diagnosis to death and place of death and the last 28 days of life (model II) time from diagnosis to death, place of death and reason for last admission. 

Conclusion

Emergency admission in last year of life is common for cancer patients, especially in the last month where the risk of hospital death was highest. Differences exist by cancer type and age, but no differences by deprivation or rurality were observed. A further economic analysis is now underway to establish estimated costs associated with emergency admissions at end-of-life. These findings will help inform future changes in emergency care for cancer patients at end-of-life in NI. AcknowledgementsThe N.Ireland Cancer Registry is funded by the Public Health Agency of N.Ireland.This research has been funded by Macmillan Cancer Support as part of the Macmillan-NICR Partnership. This work uses data provided by patients and collected by the health service as part of their care and support.