Table 2.
Emergency room and inpatient services during the last 30 days of life among non–small cell lung cancer patients who died of cancer at age 65 and older, 1999–2003*
| Services | Survived <6 mo following diagnosis |
Survived ≥6 mo following diagnosis |
||||
| SEER–Medicare | Ontario | P | SEER–Medicare | Ontario | P | |
| Estimate (95% CI) | Estimate (95% CI) | Estimate (95% CI) | Estimate (95% CI) | |||
| ER use | ||||||
| % of patients with any ER visit† | 38.3 (36.2 to 40.4) | 50.9 (48.5 to 53.3) | <.001 | 35.9 (34.3 to 37.6) | 47.9 (45.7 to 50.1) | <.001 |
| Rate of ER admissions‡ | 43.9 (42.6 to 45.2) | 67.3 (66.7 to 70.4) | <.001 | 40.1 (38.9 to 41.3) | 58.9 (57.9 to 61.2) | <.001 |
| Mean ER visits per patient among those with any ER visit | 1.34 (1.29 to 1.39) | 1.34 (1.30 to 1.38) | .959 | 1.31 (1.28 to 1.34) | 1.29 (1.26 to 1.32) | .033 |
| % of ER visits that resulted in hospitalization | 69.4 (66.2 to 72.6) | 64.0 (61.2 to 66.7) | .011 | 69.3 (66.6 to 71.9) | 66.4 (64.6 to 68.1) | .066 |
| Inpatient utilization and events, all patients | ||||||
| % of patients with hospital admissions† | 43.5 (40.7 to 46.3) | 59.3 (56.6 to 62.1) | <.001 | 39.5 (37.4 to 41.6) | 54.6 (52.5 to 56.6) | <.001 |
| Rate of hospital admissions§ | 49.9 (48.5 to 51.2) | 78.6 (78.0 to 81.7) | <.001 | 44.1 (42.9 to 45.3) | 67.1 (67.0 to 70.3) | <.001 |
| % of patients dying in hospital | 20.4 (18.7 to 22.1) | 48.5 (45.9. to 51.0) | <.001 | 19.0 (17.4 to 20.5) | 44.3 (42.1 to 46.6) | <.001 |
| Inpatient utilization and events, hospitalized patients only | ||||||
| Mean hospitalizations per person | 1.20 (1.17 to 1.23) | 1.17 (1.14 to 1.19) | .081 | 1.18 (1.16 to 1.19) | 1.14 (1.12 to 1.16) | .013 |
| Mean length of stay/hospitalization, days | 6.50 (6.23 to 6.75) | 8.26 (7.83 to 8.68) | <.001 | 6.22 (5.96 to 6.47) | 8.18 (7.9 to 8.5) | <.001 |
| % hospitalized patients treated in the ICU | 15.6 (13.6 to 17.7) | 7.1 (5.8 to 8.4) | <.001 | 14.7 (13.0 to 16.3) | 5.8 (4.7 to 6.9) | <.001 |
| Mean length of ICU stay in days per patient admitted to ICU | 4.58 (4.09 to 5.06) | 3.85 (3.08 to 4.62) | .100 | 4.64 (4.12 to 5.16) | 4.10 (3.46 to 4.74) | .182 |
| % hospitalized patients dying in hospital | 46.4 (43.9 to 48.8) | 81.3 (79.2 to 83.4) | <.001 | 47.7 (45.2 to 50.1) | 80.6 (78.6 to 82.6) | <.001 |
Adjusted for age (65–69, 70–79, ≥80 years), sex, income (2 highest quintiles, other), and urbanicity (big metropolitan, metropolitan, other). The P values for the rates in Table 2 were calculated by creating 95% confidence intervals for the difference between the two standardized rates. The P value reported is such that the (1−P)% confidence interval just includes zero. The other P values in Table 2 were calculated using a two-sample t test of the weighted data. All statistical tests were two-sided. CI = confidence interval; ER = emergency room; ICU = intensive care unit; PM = person-months; SEER = Surveillance, Epidemiology, and End Results database.
Excludes patients who were hospitalized for the entire 30-day period.
No. of patients with ER visits/100 PM. Excludes patients on days that they were in hospital.
No. of patients with hospital admission/100 PM. Excludes patients on days that they were in hospital.