Table 3.
Crude and fully adjusted marginal rate ratios for emergency presentation 30 days prior to cancer diagnosis
| Crude model | Fully adjusted model* | |||
|---|---|---|---|---|
| Proportion (95% CI) | Rate ratio (95% CI) | Proportion (95% CI) | Rate ratio (95% CI) | |
| Lung cancer | ||||
| No SMH service use | 51.2 (50.5, 51.8) | 50.2 (49.4, 50.9) | ||
| SMH service use (all) | 59.6 (56.8, 62.5) | 1.17 (1.11, 1.22) | 59.6 (56.9, 62.3) | 1.19 (1.13, 1.24) |
| No SMH service use | 51.2 (50.5, 51.8) | 50.7 (49.9, 51.4) | ||
| Severe mental illness | 62.1 (56.6, 67.6) | 1.21 (1.10, 1.32) | 62.1 (56.9, 67.3) | 1.23 (1.12, 1.33) |
| Prostate cancer | ||||
| No SMH service use | 6.6 (6.4, 6.9) | 8.4 (8.1, 8.7) | ||
| SMH service use (all) | 14.2 (11.8, 16.7) | 2.15 (1.77, 2.52) | 14.2 (12.3, 16.2) | 1.69 (1.44, 1.93) |
| No SMH service use | 6.6 (6.4, 6.9) | 8.4 (8.0, 8.8) | ||
| Severe mental illness | 17.0 (10.7, 23.4) | 2.57 (1.61, 3.53) | 17.0 (11.9, 22.2) | 2.03 (1.41, 2.65) |
| Breast cancer | ||||
| No SMH service use | 4.1 (3.9, 4.3) | 4.0 (3.8, 4.2) | ||
| SMH service use (all) | 5.7 (4.5, 6.9) | 1.38 (1.08, 1.68) | 5.7 (4.6, 6.8) | 1.42 (1.14, 1.69) |
| No SMH service use | 4.1 (3.9, 4.3) | 4.2 (4.0, 4.4) | ||
| Severe mental illness | 7.1 (4.6, 9.6) | 1.72 (1.10, 2.34) | 7.1 (4.9, 9.4) | 1.70 (1.16, 2.24) |
| Colorectal cancer | ||||
| No SMH service use | 33.1 (32.6, 33.6) | 35.3 (34.7, 35.8) | ||
| SMH service use (all) | 46.2 (43.1, 49.2) | 1.40 (1.30, 1.49) | 46.2 (43.3, 49.0) | 1.31 (1.22, 1.39) |
| No SMH service use | 33.1 (32.6, 33.6) | 35.9 (35.3, 36.5) | ||
| Severe mental illness | 48.6 (42.3, 54.8) | 1.47 (1.28, 1.66) | 48.6 (42.6, 54.5) | 1.35 (1.18, 1.52) |
* Adjusted for age, gender (for lung and colorectal cancers), ethnicity, area deprivation and stage at diagnosis. Crude model includes all individuals; fully adjusted models exclude those missing NZDep (< 0.5% for each cancer: Lung excluded n = 106 / 24,083, 0.4%; Prostate missing NZDep = 59 / 38,117 = 0.2%; Breast missing n = 81 / 35,846 = 0.2%; Colorectal missing n = 107 / 34,642 = 0.3%).Logistic regression results are presented in Table 4. For all cancers, higher area deprivation and having a non-localised cancer stage were significantly associated with an increased chance of emergency presentation, as was being Māori for all cancers except prostate. Older age (compared to those aged 55–64 years) also increased the chance of emergency presentation. These patterns were the same for the whole SMHA service use group and the severe mental illness subgroup