Three-year hospital service use trajectories of people diagnosed with cancer: a retrospective cohort study

Background: Information regarding hospital service use by people newly diagnosed with cancer can inform patterns of healthcare utilisation and resource demands. This study aims to identify characteristics of group-based trajectories of hospital service use three years after an individual was diagnosed with cancer; and determine factors predictive of trajectory group membership. Method: A group-based trajectory analysis of hospital service use of people aged ≥30 years who had a new diagnosis of cancer during 2018 in New South Wales, Australia was conducted. Linked cancer registry, hospital and mortality data were examined for a three-year period after diagnosis. Group-based trajectory models were derived based on number of hospital admissions. Multinominal logistic regression examined predictors of trajectory group membership. Results: Of the 44,577 new cancer diagnosis patients, 29,085 (65.2 %) were hospitalised at least once since their cancer diagnosis. Four distinct trajectory groups of hospital users were identified: Low (68.4 %), Very-Low (25.1 %), Moderate-Chronic (2.2 %), and Early-High (4.2 %). Key predictors of trajectory group membership were age group, cancer type, degree of cancer spread, prior history of cancer, receiving chemotherapy, and presence of comorbidities, including renal disease, moderate/serious liver disease, or anxiety. Conclusions: Comorbidities should be considered in cancer treatment and management decision making. Caring for people diagnosed with cancer with multimorbidity requires multidisciplinary shared care.