Skip to main content

Table 1 Study Characteristics

From: An international review of the patterns and determinants of health service utilisation by adult cancer survivors

Author

Year

Country

Sample characteristics

Analysis

Variables/Measures

Outcome

Quality appraisal

Andersen and Urban [36]

1998

USA

Breast cancer survivors n = 485 50–80 years old 3-20+ years post-diagnosis

Multiple logistic regression

Receipt of mammogram, usual source of care,1 recommendation by physician for mammogram and insurance coverage

Receipt of mammogram

Average

Andrykowski and Burris [45]

2010

USA

SEER database Breast cancer survivors n = 42 Colorectal cancer survivors n = 33 Hematological cancer survivors n = 38 1–5 years post-diagnosis Aged 25–75 years old

Multiple regression

Socio-demographics, cancer characteristics, mental health resource questionnaire

Use of formal and informal mental health services

Very good

Boehmer et al. [34]

2010

USA

Colorectal cancer survivors Aged 22–92 years old n = 253

Cox proportional hazard models

Colonoscopies, sigmoidoscopy, cancer type, stage, co-morbidities, outpatient visits, socio-demographics

Receipt of colorectal surveillance procedures

Very good

Cooper et al. [29]

2000

USA

SEER-MEDICARE database Colorectal cancer survivors Localised disease Surgically treated >65 years old n = 5, 716

Chi-square test

Socio-demographics, inpatient claims, outpatient claims, use of endoscopic procedures (colonoscopy, polypectomy or biopsy)

Receipt of colorectal surveillance procedures

Very good

Cooper and Payes [28]

2006

USA

SEER-MEDICARE database Colorectal cancer survivors >65 years old n = 62, 882 survived 1 year follow-up n = 35, 784 survived 3 year follow-up

Logistic regression

Medicare claims2 for colonoscopy, sigmoidoscopy or barium enema, co-morbidities

Use of surveillance procedures for colorectal cancer within 3 years of diagnosis

Very good

Cooper, Kou and Reynolds [31]

2008

USA

SEER database Colorectal cancer survivors >65 years old n = 9, 426

Multivariate regression

Number of physician visits, receipt of carcino-embryonic antigen blood test (CEA),3 colonoscopy, CT and PET scans

Adherence to guidelines for cancer follow-up

Good

Doubeni et al. [27]

2006

USA

Breast cancer survivors n = 797 at baseline (end of treatment) n = 262 after 5 yrs >55 years old 4 geographically diverse Health Maintenance Organisations (HMOs).4

Generalised estimated equations (GEE)

Receipt of mammograms. age, date and stage at/of diagnosis, treatment. co-morbidities. visits to primary care provider (primary care physician) and outpatient visits

Receipt of yearly mammogram and visits to physicians

Very good

Earle et al. [23]

2003

USA

SEER database Breast cancer survivors > 65 years old, n = 5,965 Controls n = 6,062

Multivariate regression

Frequency of visits to primary care physician, oncologists, other and teaching hospitals, receipt of flu vaccine, lipid test, cervical exam, colon exam, bone densitometry and diabetes test

Visits to physicians and receipt of preventive medicine

Very good

Earle and Neville [19]

2004

USA

SEER database Colorectal cancer survivors > 65 years old n = 14,884

Logistic regression

Co-morbidities, socio-demographics, receipt of flu vaccine, lipid testing, bone densitometry and cervical screening

Visits to physicians and receipt of preventive medicine

Very good

Earle, Neville and Fletcher [43]

2007

USA

Breast, lymphoma, colorectal, melanoma and other cancer survivors Mean age 60 years n = 1,111 Controls n = 4,444

Logistic regression `

Mental health diagnoses, co-morbidities, socio-demographics, use of primary care physician, oncologist, psychiatrists, psychologists, social workers and inpatient hospitalisations (both general and mental).

Use of mental health provider services

Good

Ellison et al. [33]

2003

USA

SEER database Colorectal cancer survivors >65 years old n = 52, 105

Kaplan-Meier survival analysis Unconditional regression analysis Cox regression

Socio-demographic, hospital and clinical characteristics, receipt of colonoscopy, sigmoidoscopy, endoscopy and barium enema

Differential receipt of colonoscopy, sigmoidoscopy, endoscopy and barium enema by race

Good

Gray et al. [41]

2000

Canada

Breast cancer survivors n = 731 Histologically confirmed and invasive

Stepwise logistic regression

Use of specialised supportive care services, wish to use services that were not accessed, social and demographic characteristics.

Use of professional supportive care services provided by the Ontario health care system

Very good

Gray et al. [42]

2002

Canada

Breast cancer survivors 63 % <60 years old 23–36 months post-diagnosis n = 731

Logistic regression

Supportive care from physicians and nurses, socio-demographics, illness and treatment information

Use of professional supportive care

Good

Grunfeld et al. [16]

1999

UK

Breast cancer survivors n = 148 Two district general hospitals

Two-tailed t-test and chi-square

Record of visits, average cost of visits, out-of patient expenses, waiting times, lost earnings and lost earnings of accompanying person

GP follow-up vs. Hospital follow-up. Cost-effectiveness and cost to patient,

Average

Grunfeld et al. [17]

2011

Canada

Breast cancer survivors n = 408 Nine tertiary cancer centres

Two-tailed t-test

Use of survivorship care plans (vs. no survivorship care plans) in primary care physician led follow-up. Frequency of visits to oncologists.

Primary care physician led follow-up

Very good

Keating et al. [25]

2006

USA

SEER-MEDICARE database Breast cancer survivors Stage 1 or 2 Underwent surgery >65 years old

Repeated-measures logistic regression

Mammogram receipt, visits to primary care physician medical oncologist, general surgeon, radiation oncologist and other specialists, socio-demographics

Factors related to mammography use

Very good

Keating et al. [11]

2007

USA

SEER database Breast cancer survivors >65 years old n = 37,967 in year 1 n = 30,406 in year 2 n = 23,016 in year 3

Repeated-measures logistic regression

Receipt of bone scans, tumour antigen tests (TAT), Chest x-rays and other abdominal/chest imaging, frequency of visits to physicians and socio-demographics

Receipt of a number of surveillance procedures and visits to physicians over time

Very good

Khan et al. [38]

2010

UK

GPRD database Breast cancer survivors N = 18, 612 Colorectal cancer survivors N = 5, 764 Prostate cancer survivors N = 4, 868 >30 years old 5 years post-diagnosis Controls N = 116,418

Multivariate regression

Socio-demographics, use of primary care, frequency of visits

Primary care consultations

Very good

Khan, Watson and Rose [20]

2011

UK

GPRD database Prostate cancer survivors N = 4,868 Breast cancer survivors N = 18,612 Colorectal cancer survivors N = 5,764 Controls N = 145,662

Logistic regression

Co-morbidities, screening (PSA, cervical, mammogram), receipt of preventative procedures and socio-demographics

Receipt of screening and preventative care

Very good

Knopf et al. [37]

2001

USA

SEER database Colorectal cancer survivors >65 years old n = 52, 283

Kaplan-Meier survival analysis

Receipt of colonoscopy, sigmoidoscopy, endoscopy and barium enema, age, tumour stage at diagnosis and year of diagnosis

Receipt of bowel surveillance procedures

Very Good

Lafata et al. [30]

2001

USA

Colorectal cancer survivors n = 251

Kaplan-Meier survival analysis Cox proportional hazards

Socio-demographics, receipt of colonoscopy, CEA, barium enema, chest x-ray, MRI’s, ultrasounds and liver analysis

Receipt of colon screening procedures and other procedures

Very good

Mahboubi et al. [15]

2007

France

Colorectal cancer survivors <65 years old N = 389

Logistic regression

Co-morbidities, chest radiograph, abdominal ultrasound, colonoscopy, CT, TAT, blood tests and reason for testing (routine or symptomatic)

Characteristics associated with visits to GPs

Very good

Mandelblatt et al. [13]

2006

USA

Breast cancer survivors n = 418 Stage 1 and 2

Multivariate linear regression

Calendar diary of health service use, socio-demographics, cancer treatment information, co-morbidities and psychological status survey

Patterns and determinants of health service use

Very good

Mayer et al. [35]

2007

USA

NCI 2003 HINTS5

n = 619 Breast cancer survivors n = 119 Prostate cancer survivors n = 62 Colorectal cancer survivors n = 49 Others n = 389

Logistic regression

Based on the health belief model (HBM),6 cancer communication, cancer history, general cancer knowledge, cancer risk and screening, health status and demographics.

Screening practices and beliefs

Very good

McBean, Yu and Virnig [39]

2008

USA

SEER database: Uterine cancer survivors >65 years old n = 14,575 Controls n = 58,420

Multivariate logistic regression Generalised equation modelling

Receipt of flu vaccine, bone densitometry, colorectal screening and mammogram no. of physician services and socio-demographics

Use of preventive services and frequency of physician visits

Very good

Mols, Helfenrath and van de Poll-Fanse [14]

2007a

Netherlands

Endometrial cancer Prostate cancer Non-Hodgkin’s lymphoma survivors n = 1,112

Linear regression Multivariate linear regression

SF-36, self-reported health service use, frequency of visits, co-morbidities and socio-demographics

Patterns of physician use

Very good

Mols, Coebergh and van de Poll-Fanse [22]

2007b

Netherlands

Endometrial cancer Prostate cancer, Hodgkin’s and non-Hodgkin’s lymphoma survivors n = 1,231

Chi-square and multivariate logistic regression

Co-morbidity, socio-demographics, use of medical specialist, general practitioner, additional services (physiotherapist. and psychologist)

Frequency of physician use

Very good

Oleske et al. [47]

2004

USA

Breast cancer survivors Aged between 21–65 years n = 123

Multivariate logistic regression

Use and frequency of physician and admissions, services in past 12 months. reasons for hospitalisations, SRS (social responsiveness scale) and CES-D (depression scale)

Determination of factors associated with hospitalisation

Very good

Peuckmann et al. [12]

2009

Denmark

Breast cancer survivors n = 1,316 Controls n = 4,865

Risk ratios and multiple logistic regression analysis

Frequency of physical visits, socio-demographics, physical activity and BMI. HR-QOL (SF-36) and chronic pain

Frequency and determinants of health service use

Very good

Schapira, McAuliffe and Nattinger [32]

2000

USA

SEER database Breast cancer survivors >65 years old n = 3,885

Logistic model

Receipt of mammogram, co-morbidity, socio-economic status (SES) and preventive treatment received

Receipt of Mammogram over two year period

Good

Schootman et al. [44]

2008

USA

SEER database Breast cancer survivors >65 years old n = 47, 643

Restricted iterative generalised least squares and first-order marginal quasi-likelihood estimation analysis

Frequency of Ambulatory-Care-Sensitive Hospitalizations (ACSH)7 SES, co-morbidity, demographics, availability of medical care, visits to primary care physician and oncologists

Frequency of Ambulatory-Care-Sensitive Hospitalizations

Very good

Simpson, Carlson and Trew [18]

2001

USA

Breast cancer survivors Time point 1 n = 46 Time point 4 n = 30 Controls Time point 1 n = 43 Time point 4 n = 25

ANOVA

Average cost of care, no. of cancer centre visits and a number of psychological distress indicators including BDI, POMS and Mental adjustment to cancer scale

Billing of Health care as a proxy to use. Visits to cancer centre Correlation of billing to distress.

Good

Snyder et al. [9]

2008a

USA

SEER database Colorectal cancer survivors >65 years old n = 1,541

Poisson regression and logistic regression

Clinical and socio-demographic characteristics, visits to primary care physician, oncologist or other physicians. Receipt of influenza vaccine, cholesterol screening, mammogram, cervical screening and bone densitometry

Frequency of physician visits and receipt of preventive care

Very good

Snyder et al. [10]

2008b

USA

SEER database Colorectal cancer survivors >65 years old n = 20,068

Poisson regression and logistic regression analysis

Co-morbidities, socio-demographics, visits to primary care physician, oncologist and other physicians, receipt of influenza vaccine, cholesterol screening, mammogram, and bone densitometry

Visits to physicians and receipt of preventive care

Good

Snyder et al. [24]

2009a

USA

SEER database Breast cancer survivors >65 years old n = 23, 73 Controls n = 23, 731

Poisson regression and logistic regression analysis

Use of physician and oncology services, receipt of 5 preventive care services and socio-demographics.

Visits to physicians and oncologists and preventive medicine

Good

Snyder et al. [26]

2009b

USA

SEER database Breast cancer survivors >65 years old Stages 1–3 n = 1,961 Controls n = 1,961

Poisson regression and logistic regression analysis

Co-morbidities, clinical and demographic characteristics, visits to primary care physician, oncologists and other physicians

Frequency of visits to physicians

Good

Van de Poll-Fanse et al. [21]

2006

Netherlands

Breast cancer survivors Invasive n = 183

Logistic regression

Co-morbidities, spontaneously reported problems, use of GP, medical specialist and physiotherapist, health status and psychological well-being

Use of physician services

Good

Yu, McBean and Virnig [40]

2007

USA

SEER database Colorectal cancer survivors >65 years old n = 112, 737.

Logistic regression and poisson regression

Socio-demographic characteristics, co-morbidities, receipt of mammogram, visits to primary care physician, Gynaecologists only, oncologists and other

Receipt of mammogram and visits to physicians

Good

  1. 1Usual source of care refers to whether an individual receives care from the same physician or different physicians; 2Medicare is a government-funded medical care plan in USA, whereby individuals aged 65 and over that covers medical expenses such as doctor's visits, hospital stays, drugs and other treatment; 3CEA testing is used as a tumour marker for particular cancers, such as colorectal; 4HMOs provide their members with medical services for a fixed fee; 5NCI HINTS is the Health Information National Trends Survey, which collects nationally represented information on how the American public find and use information on cancer; 6Developed by Hochbaum (1958) is an explanatory and predictive model of health behaviours and includes attitudes and beliefs of an individual; 7ACSH are hospitalizations which could have been prevented if primary care services had been initially accessed by the individual.