Variations in Emergency Service Utilization among Cancer Survivors: Results from the Pan-Canadian Experiences of Cancer Patients in Transition Study Survey
Table 3
Multivariable analysis of factors associated with increased emergency service utilization in the first year after cancer treatment completion.
Characteristic
1–3 times
>3 times
RRR (95% CI)
value
RRR (95% CI)
value
Sex
Male
(Base)
(Base)
Female
0.93 (0.73–1.19)
0.58
0.92 (0.64–1.32)
0.66
Age at diagnosis
18–44
(Base)
(Base)
44–65
0.72 (0.52–0.99)
0.04
0.44 (0.27–0.71)
0
≥65
0.49 (0.33–0.72)
0
0.35 (0.19–0.62)
0
Marital status
Single
(Base)
(Base)
Married/partnered
0.72 (0.53–0.99)
0.04
0.66 (0.42–1.04)
0.07
Divorced/separated/widowed
0.66 (0.46–0.94)
0.02
0.58 (0.34–0.97)
0.04
Prefer not to answer
2.22 (0.85–5.79)
0.1
2.81 (0.73–10.78)
0.13
Coping with challenges
Very easy/easy
(Base)
(Base)
Neither easy nor hard
1.16 (0.95–1.42)
0.15
1.07 (0.78–1.47)
0.67
Hard/very hard
1.11 (0.77–1.59)
0.58
0.79 (0.46–1.34)
0.38
Missing
2.02 (0.48–8.43)
0.33
1.05 (0.13–8.68)
0.97
Sharing worries
Very easy/easy
(Base)
(Base)
Neither easy nor hard
0.87 (0.71–1.07)
0.19
0.88 (0.63–1.22)
0.43
Hard/very hard
0.89 (0.69–1.14)
0.34
0.85 (0.58–1.24)
0.4
Missing
1.75 (0.34–8.94)
0.5
2.33 (0.33–16.29)
0.39
Asking questions
Very easy/easy
(Base)
(Base)
Neither easy nor hard
1.12 (0.88–1.41)
0.35
0.94 (0.65–1.36)
0.73
Hard/very hard
0.88 (0.61–1.27)
0.48
0.9 (0.53–1.52)
0.7
Missing
0
0.97
0.97 (0.11–8.51)
0.98
Current insurance
Government-sponsored
(Base)
(Base)
Private
1.02 (0.8–1.3)
0.88
0.74 (0.51–1.06)
0.1
No insurance
0.8 (0.6–1.07)
0.14
0.74 (0.48–1.13)
0.17
No response/other
0.87 (0.65–1.16)
0.33
0.59 (0.37–0.92)
0.02
Born in Canada
Yes
(Base)
(Base)
No
1.1 (0.85–1.42)
0.48
0.94 (0.61–1.45)
0.79
Prefer not to answer
0.71 (0.2–2.55)
0.6
4.19 (0.95–18.53)
0.06
Language most spoken at home
English
(Base)
(Base)
French
1.55 (1.25–1.93)
0
2.11 (1.53–2.91)
0
Other
1.16 (0.74–1.82)
0.51
1.05 (0.5–2.22)
0.9
Highest level of education
≤High school diploma
(Base)
(Base)
<University degree
1.07 (0.88–1.32)
0.49
0.78 (0.57–1.07)
0.13
University degree
0.96 (0.75–1.22)
0.73
0.75 (0.52–1.1)
0.15
No response
1.35 (0.72–2.55)
0.35
0.94 (0.35–2.53)
0.9
Population density
≤10,000 people
(Base)
(Base)
10,000 to 50,000 people
0.76 (0.59–0.97)
0.03
0.74 (0.51–1.09)
0.13
>50,000 people
0.76 (0.63–0.92)
0.01
0.77 (0.57–1.03)
0.08
No response
1.43 (0.57–3.56)
0.44
1.6 (0.43–5.95)
0.48
Employment
Full- or part-time
(Base)
(Base)
Sick leave/disability/unemployed
1.19 (0.84–1.68)
0.32
1.39 (0.85–2.28)
0.19
Retired
1.41 (1.11–1.78)
0
1.54 (1.05–2.25)
0.03
No response/other
1.22 (0.82–1.81)
0.32
0.71 (0.34–1.45)
0.35
Income
≤$25,000
(Base)
(Base)
$25,000 to <$50,000
0.72 (0.54–0.98)
0.04
0.58 (0.37–0.91)
0.02
$50,000 to <$75,000
0.63 (0.44–0.88)
0.01
1.07 (0.67–1.73)
0.77
≥$75,000
0.58 (0.41–0.82)
0
0.72 (0.43–1.21)
0.21
Prefer not to answer
0.87 (0.63–1.2)
0.38
1.02 (0.64–1.62)
0.95
Overall quality of life
Very poor/poor/fair
(Base)
(Base)
Good/very good
0.68 (0.51–0.92)
0.01
0.48 (0.31–0.74)
0
Missing
1.5 (0.44–5.09)
0.52
0.29 (0.03–2.78)
0.28
Physical health
Very poor/poor/fair
(Base)
(Base)
Good/very good
1.01 (0.78–1.31)
0.92
0.98 (0.67–1.44)
0.92
Missing
9.43 (0.95–93.02)
0.05
9.01 (0.5–161.77)
0.14
Emotional health
Very poor/poor/fair
(Base)
(Base)
Good/very good
0.7 (0.56–0.89)
0
0.77 (0.55–1.09)
0.14
Missing
0.87 (0.52–1.46)
0.59
1.15 (0.56–2.32)
0.71
Unmet practical concern
No
(Base)
(Base)
Yes
1.17 (0.97–1.41)
0.1
1.57 (1.18–2.1)
0
Unmet emotional concern
No
(Base)
(Base)
Yes
1.18 (0.97–1.45)
0.1
1.28 (0.93–1.76)
0.14
Unmet physical concern
No
(Base)
(Base)
Yes
1.03 (0.85–1.24)
0.77
1.02 (0.76–1.37)
0.89
Number of comorbidities
None
(Base)
(Base)
1-2
0.94 (0.79–1.13)
0.51
1.44 (1.07–1.95)
0.02
≥3
0.97 (0.69–1.35)
0.85
1.97 (1.22–3.18)
0.01
Cancer type
Breast
0.65 (0.47–0.9)
0.01
0.47 (0.28–0.77)
0
Hematologic
0.75 (0.52–1.07)
0.11
0.69 (0.4–1.18)
0.17
Colorectal
(Base)
(Base)
Melanoma
0.4 (0.28–0.57)
0
0.35 (0.2–0.63)
0
Prostate
0.54 (0.4–0.71)
0
0.45 (0.29–0.69)
0
Year of cancer diagnosis
≤2012
(Base)
(Base)
2013
0.9 (0.73–1.12)
0.35
0.77 (0.56–1.05)
0.1
≥2014
0.94 (0.72–1.21)
0.61
0.73 (0.49–1.08)
0.12
Surgery
No
(Base)
(Base)
Yes
1.31 (1.01–1.71)
0.04
1.27 (0.85–1.91)
0.25
Radiotherapy
No
(Base)
(Base)
Yes
0.84 (0.69–1.03)
0.09
0.88 (0.65–1.2)
0.42
Systemic therapy
No
(Base)
(Base)
Yes
1.1 (0.83–1.46)
0.52
1.06 (0.68–1.66)
0.79
Time of last treatment
<1 year ago
(Base)
(Base)
1–3 years ago
0.81 (0.61–1.07)
0.14
0.72 (0.48–1.1)
0.13
3–5 years ago
0.69 (0.51–0.95)
0.02
0.65 (0.41–1.03)
0.07
No treatment
0.6 (0.4–0.9)
0.01
0.64 (0.36–1.16)
0.14
Currently receiving or received prescribed medication to prevent cancer recurrence
No
(Base)
(Base)
Yes
0.84 (0.64–1.1)
0.21
0.85 (0.56–1.31)
0.47
Unsure/blank
1.09 (0.56–2.13)
0.8
1.43 (0.62–3.28)
0.4
Enrolled in a clinical trial
Yes
(Base)
(Base)
No
0.75 (0.59–0.96)
0.02
0.54 (0.38–0.76)
0
No response
0.74 (0.45–1.22)
0.24
0.54 (0.25–1.14)
0.1
Times visit/speak in first 12 months—family doctor/practitioner
Not at all
(Base)
(Base)
1–3 times
1.48 (1.11–1.96)
0.01
1.37 (0.84–2.24)
0.21
>3 times
2.2 (1.63–2.97)
0
3.59 (2.2–5.85)
0
N/A†
1.98 (1.24–3.17)
0
3.64 (1.88–7.05)
0
Times visit/speak in first 12 months—oncologist/hematologist
Not at all
(Base)
(Base)
1–3 times
1.32 (0.88–1.99)
0.18
0.72 (0.38–1.35)
0.3
>3 times
2.57 (1.69–3.9)
0
3.04 (1.64–5.63)
0
N/A
2.73 (1.02–7.32)
0.05
5.04 (1.59–15.96)
0.01
Healthcare provider in charge of follow-up cancer care
PCP
(Base)
(Base)
Oncologist
1.11 (0.84–1.46)
0.46
0.74 (0.48–1.15)
0.18
Both
0.99 (0.77–1.28)
0.96
0.81 (0.54–1.2)
0.29
No one/unsure
0.95 (0.5–1.83)
0.88
2.15 (0.97–4.79)
0.06
PCP involvement in follow-up cancer care
Not at all involved
(Base)
(Base)
Not very involved/somewhat involved
0.87 (0.65–1.17)
0.36
0.76 (0.48–1.21)
0.25
Very involved
0.75 (0.54–1.05)
0.09
0.75 (0.44–1.26)
0.27
Care coordination among healthcare providers involved in follow-up cancer care
Very good/good
(Base)
(Base)
Fair/poor/very poor
0.85 (0.69–1.06)
0.15
1.12 (0.81–1.54)
0.51
Received a care plan after cancer treatment
Yes
(Base)
(Base)
No
0.85 (0.71–1.03)
0.1
1.09 (0.8–1.47)
0.59
Not applicable/blank
0.83 (0.63–1.09)
0.18
1.54 (1.04–2.3)
0.03
Received or saw a copy of medical records after cancer treatment
