Abstract
Background and Aims
Virtual care has long been used in cancer services to support rural and remote populations, with the COVID-19 pandemic contributing to its rapid expansion into urban areas. To improve virtual cancer care, it is crucial to understand its outcomes compared to face-to-face care and how these may differ between patient cohorts. This study aims to compare the subsequent healthcare utilisation of people accessing outpatient services via virtual care versus face-to-face care, exploring how this compares before and during the COVID-19 pandemic period. The findings will help inform recommendations for post-pandemic models of outpatient cancer care.
Methods
This retrospective cohort study included individuals aged ≥ 18 years, who attended outpatient oncology services in Victoria, Australia, from January 1, 2017, to December 31, 2021. The study period was divided into two phases: pre-COVID-19 restrictions (January 2017 to February 2020) and during COVID-19 restrictions (March 2020 to December 2021). Outcomes measured were subsequent inpatient admissions, emergency department visits, and mortality within 3, 30, and 90 days following an index outpatient encounter. Cause-specific hazard modelling was employed to examine the association between the type of care (face-to-face or virtual) and subsequent hospital use, adjusting for covariates such as country of birth, language spoken at home, Charlson comorbidities, urban or rural residence, cancer type, stage etc, and treating death as a competing event.
Expected outcomes
By November 2024, we will have the following results available:
• The subsequent health service use outcomes of virtual versus face-to-face cancer care, evaluated through hazard ratios for both time periods.
• Whether these associations vary across different population cohorts, including those from culturally and linguistically diverse backgrounds and those residing in rural versus urban areas.
Challenges
Evaluating the use of virtual care when patients experience multiple encounters using different modes (both virtual and face-to-face) within the same follow-up period is challenging and was addressed in this study by focusing on the index encounter for each time period. Additionally, a sensitivity analysis will be conducted with patients who had only one encounter during the study period.
Implications/ Conclusions
Leveraging real-world data is essential to tailor virtual cancer care to patient needs and ensure they meet the requirements of all intended users. This study is the first phase of a larger project that examines the outcomes of virtual care in NSW, Victoria, and Queensland. The findings will provide valuable insights into the effectiveness of virtual cancer care and generate evidence to support its integration into Australian health systems.
Virtual care has long been used in cancer services to support rural and remote populations, with the COVID-19 pandemic contributing to its rapid expansion into urban areas. To improve virtual cancer care, it is crucial to understand its outcomes compared to face-to-face care and how these may differ between patient cohorts. This study aims to compare the subsequent healthcare utilisation of people accessing outpatient services via virtual care versus face-to-face care, exploring how this compares before and during the COVID-19 pandemic period. The findings will help inform recommendations for post-pandemic models of outpatient cancer care.
Methods
This retrospective cohort study included individuals aged ≥ 18 years, who attended outpatient oncology services in Victoria, Australia, from January 1, 2017, to December 31, 2021. The study period was divided into two phases: pre-COVID-19 restrictions (January 2017 to February 2020) and during COVID-19 restrictions (March 2020 to December 2021). Outcomes measured were subsequent inpatient admissions, emergency department visits, and mortality within 3, 30, and 90 days following an index outpatient encounter. Cause-specific hazard modelling was employed to examine the association between the type of care (face-to-face or virtual) and subsequent hospital use, adjusting for covariates such as country of birth, language spoken at home, Charlson comorbidities, urban or rural residence, cancer type, stage etc, and treating death as a competing event.
Expected outcomes
By November 2024, we will have the following results available:
• The subsequent health service use outcomes of virtual versus face-to-face cancer care, evaluated through hazard ratios for both time periods.
• Whether these associations vary across different population cohorts, including those from culturally and linguistically diverse backgrounds and those residing in rural versus urban areas.
Challenges
Evaluating the use of virtual care when patients experience multiple encounters using different modes (both virtual and face-to-face) within the same follow-up period is challenging and was addressed in this study by focusing on the index encounter for each time period. Additionally, a sensitivity analysis will be conducted with patients who had only one encounter during the study period.
Implications/ Conclusions
Leveraging real-world data is essential to tailor virtual cancer care to patient needs and ensure they meet the requirements of all intended users. This study is the first phase of a larger project that examines the outcomes of virtual care in NSW, Victoria, and Queensland. The findings will provide valuable insights into the effectiveness of virtual cancer care and generate evidence to support its integration into Australian health systems.
| Original language | English |
|---|---|
| Pages | 13-14 |
| Number of pages | 2 |
| Publication status | Published - 19 Nov 2024 |
| Event | Western Health Research Network 2024 Research Symposium. - Duration: 19 Nov 2024 → 19 Nov 2024 |
Conference
| Conference | Western Health Research Network 2024 Research Symposium. |
|---|---|
| Period | 19/11/24 → 19/11/24 |