TY - JOUR
T1 - Healthcare utilization of breast cancer patients following telephone-based consultations of oncology nurse navigator via telemedical care
AU - Adler, Gila
AU - Kaufman, Galit
AU - Simon-Tuval, Tzahit
N1 - Publisher Copyright: © 2019 Adler et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Objectives To characterize breast cancer patients who received telephone-based consultations of oncology nurse navigator via telemedical care (TMC patients) and analyze their healthcare utilization (HCU) one year before and after receiving this service. Methods A retrospective study among Maccabi Healthcare Services enrollees that were newly diagnosed during 2016 (n = 1035). HCU, demographic characteristics and comorbidities were obtained from computerized database. Multivariable ordered logit model was specified for the determinants of HCU by quarters. Independent variables included: annual number of telephone-based consultations, gap between diagnosis and first consultation, age, socioeconomic status, eligibility for disability and income security benefits, and comorbidities. Results Twenty-two percent of our cohort were TMC patients. Compared to others, these patients were younger and had a lower prevalence of hypertension. A higher proportion of these patients received disability benefits, and a lower proportion received income security benefits. The total average annual HCU of TMC patients (n = 107) before first consultation was $8857 and increased to $44130 in the first year following it (p<0.001), predominantly due to a significant increase in outpatient visits ($20380 vs. $3502, p<0.001) and medication costs ($19339 vs. $1758, p<0.001). The multivariable model revealed that each additional telephone-based consultation decreased the likelihood to be in the lowest quarter of the HCU distribution by 1.1 percentage points (p = 0.015), and increased the likelihood to be in the upper quarter of the HCU distribution by 1.1 percentage points (p = 0.016). Conclusions There was a significant increase in outpatient care and medications usage following first consultation. Moreover, a more intense use of this service was associated with elevated HCU. This result may stem from the proactive nature of the telemedical care.
AB - Objectives To characterize breast cancer patients who received telephone-based consultations of oncology nurse navigator via telemedical care (TMC patients) and analyze their healthcare utilization (HCU) one year before and after receiving this service. Methods A retrospective study among Maccabi Healthcare Services enrollees that were newly diagnosed during 2016 (n = 1035). HCU, demographic characteristics and comorbidities were obtained from computerized database. Multivariable ordered logit model was specified for the determinants of HCU by quarters. Independent variables included: annual number of telephone-based consultations, gap between diagnosis and first consultation, age, socioeconomic status, eligibility for disability and income security benefits, and comorbidities. Results Twenty-two percent of our cohort were TMC patients. Compared to others, these patients were younger and had a lower prevalence of hypertension. A higher proportion of these patients received disability benefits, and a lower proportion received income security benefits. The total average annual HCU of TMC patients (n = 107) before first consultation was $8857 and increased to $44130 in the first year following it (p<0.001), predominantly due to a significant increase in outpatient visits ($20380 vs. $3502, p<0.001) and medication costs ($19339 vs. $1758, p<0.001). The multivariable model revealed that each additional telephone-based consultation decreased the likelihood to be in the lowest quarter of the HCU distribution by 1.1 percentage points (p = 0.015), and increased the likelihood to be in the upper quarter of the HCU distribution by 1.1 percentage points (p = 0.016). Conclusions There was a significant increase in outpatient care and medications usage following first consultation. Moreover, a more intense use of this service was associated with elevated HCU. This result may stem from the proactive nature of the telemedical care.
UR - http://www.scopus.com/inward/record.url?scp=85065569387&partnerID=8YFLogxK
U2 - https://doi.org/10.1371/journal.pone.0216365
DO - https://doi.org/10.1371/journal.pone.0216365
M3 - Article
C2 - 31048852
SN - 1932-6203
VL - 14
JO - PLoS ONE
JF - PLoS ONE
IS - 5
M1 - e0216365
ER -
