4.2 Article

Predictors of Unplanned Hospitalizations in Patients With Nonmetastatic Lung Cancer During Chemotherapy

Journal

ONCOLOGY NURSING FORUM
Volume 44, Issue 5, Pages E203-E212

Publisher

ONCOLOGY NURSING SOC
DOI: 10.1188/17.ONF.E203-E212

Keywords

SEER-Medicare; lung neoplasms; comorbidity; hospitalization; chemotherapy

Funding

  1. University of Utah from the National Institute of Nursing Research of the National Institutes of Health [T32NR013456]

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Purpose/Objectives:To determine. predictors of unplanned hospitalizations in patients with lung cancer to receive chemotherapy in the outpatient setting and examine the potential financial burden of these events. Design: Retrospective, longitudinal cohort study. Setting: The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Sample: Of 104,388 incident cases of lung cancer diagnosed from 2005-2009, 2,457 cases of patients with lung cancer who received outpatient Chemotherapy were identified. Patients were aged 66 years or older at diagnosis, had uninterrupted Medicare Part A and B coverage with no health maintenance organization enrollment and received IV chemotherapi atleast once. Methods: Generalized estimating equations was used. Main Research Variables: Patient age, sex, race, marital status, degree of residential urbanization, median income, education level, stage, receipt of radiation therapy, and comorbidities. Findings: Younger age, non-White race, lower education, higher income, receipt of radiation therapy, and lack of preexisting comorbidity were significant predictors of the likelihood of an initial unplanned hospitalization for lung dancer. Non White race, receipt of radiation therapy, and comorbidity were factors associated with an increased number of hospitalizations. Conclusions: Unpianned-hospitafizations are frequent, disruptive, and costly. This article defines areas for further exploration to identify patients at high risk for unexpected corn plications. Implications for Nursing: This article represents a foundation for development of risk models to enable nursing evaluation of patient risk for chemotherapy treatment interruption and unplanned hospitalization.

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