The relationship between Eastern Cooperative Oncology Group performance status and healthcare resource utilization among patients with advanced or metastatic colorectal, lung or gastric cancer.

Lisa M Hess, David Smith, Zhanglin L Cui, Leslie Montejano, Astra M Liepa, William Schelman, Lee Bowman
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引用次数: 2

Abstract

Aims: The ability of a patient to receive anti-cancer treatment depends on a variety of factors, including performance status (PS), which is typically measured using the Eastern Cooperative Oncology Group (ECOG) scale. This study hypothesized that there would be a strong and positive correlation between ECOG PS values and healthcare resource utilization (HCRU) and a strong and negative correlation with the use of anti-cancer therapy.

Materials and methods: Patients with colorectal, lung or gastric cancer were included in this retrospective analysis of administrative claims data linked to electronic medical records (EMR). All-cause HCRU (hospitalization/inpatient care, emergency room visits, systemic anti-cancer therapy, radiation therapy, outpatient physician visits, hospice, home health care and key supportive care treatments such as anti-emetics, hematopoietic treatments, transfusions, and durable medical equipment) was evaluated by baseline ECOG PS value and PS over time. Adjusted multivariable regression analysis was used to assess the relationship between baseline ECOG PS and HCRU. Regression analyses were conducted to explore the relationship between other baseline variables and HCRU.

Results: There were 1311 patients included in this study. There was low correlation between PS and any HCRU variable or receipt of anti-cancer therapy (correlation coefficients all <0.10). In regression analyses, the proportion of patients with poor PS (PS = 2+) who were hospitalized was not significantly different from those with good PS (PS = 0/1) (28.9% versus 19.3%, p = .07).

Limitations: The low rate of reporting of PS and the small sample size of patient groups in this study.

Conclusions: There is very little evidence of a relationship between ECOG PS and HCRU, ECOG PS, or anti-cancer therapy in this study, in part due to low rates of and lack of variability in reported PS. There is some evidence that baseline comorbidities were significantly associated with HCRU and should be accounted for in future research evaluating HCRU.

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晚期或转移性结、肺、胃癌患者东方肿瘤合作组绩效状况与医疗资源利用的关系
目的:患者接受抗癌治疗的能力取决于多种因素,包括表现状态(PS),通常使用东部肿瘤合作组织(ECOG)量表进行测量。本研究假设ECOG PS值与卫生保健资源利用率(HCRU)呈强正相关,与抗癌治疗的使用呈强负相关。材料和方法:本研究回顾性分析了与电子病历(EMR)相关的行政索赔数据,包括结直肠癌、肺癌或胃癌患者。全因HCRU(住院/住院治疗、急诊室就诊、全身抗癌治疗、放射治疗、门诊医生就诊、临终关怀、家庭保健和关键支持性护理治疗,如止吐药、造血治疗、输血和耐用医疗设备)通过基线ECOG PS值和随时间推移的PS进行评估。采用校正多变量回归分析评估基线ECOG PS与HCRU之间的关系。回归分析其他基线变量与HCRU的关系。结果:本研究共纳入1311例患者。PS与任何HCRU变量或接受抗癌治疗的相关性均较低(相关系数均p = .07)。局限性:本研究中PS报告率低,患者组样本量小。结论:在本研究中,很少有证据表明ECOG PS与HCRU、ECOG PS或抗癌治疗之间存在关系,部分原因是报道的PS发生率低且缺乏可变性。有一些证据表明,基线合并症与HCRU显著相关,应在未来评估HCRU的研究中加以考虑。
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Journal of Drug Assessment
Journal of Drug Assessment PHARMACOLOGY & PHARMACY-
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