Associations of patient-reported care satisfaction with symptom burden and healthcare use in hospitalized patients with cancer
Menée aux Etats-Unis par questionnaire auprès de 1 576 patients atteints d'un cancer, cette étude prospective analyse l'association entre une hospitalisation non programmée, la durée du séjour, les symptômes et la satisfaction vis-à-vis de la qualité et de la coordination des soins reçus
Background : Hospitalized patients with cancer often experience a high symptom burden, which may impact care satisfaction and healthcare utilization. Methods : We prospectively enrolled patients with cancer and unplanned hospitalizations from September 2014 to April 2017. Upon admission, we assessed patients’ care satisfaction (FAMCARE items: satisfaction with care coordination and speed with which symptoms are treated) and physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire-4 [PHQ-4]) symptoms. We used regression models to identify factors associated with care satisfaction and associations of satisfaction with symptom burden and hospital length of stay (LOS). Results : Among 1,576 participants, most reported being “satisfied”/ “very satisfied” with care coordination (90%) and speed with which symptoms are treated (89%). Older age (coordination: B < 0.01, P = 0.02, speed: B = 0.01, P < 0.01) and admission to a dedicated oncology service (B = 0.20, P < 0.01 for each) were associated with higher satisfaction. Higher satisfaction with care coordination was associated with lower ESAS-physical (B = − 1.28, P < 0.01), ESAS-total (B = − 2.73, P < 0.01), PHQ4-depression (B = − 0.14, P = 0.02), and PHQ4-anxiety (B = − 0.16, P < 0.01) symptoms. Higher satisfaction with speed with which symptoms are treated was associated with lower ESAS-physical (B = − 1.32, P < 0.01), ESAS-total (B = − 2.46, P < 0.01), PHQ4-depression (B = − 0.14, P = 0.01), and PHQ4-anxiety (B = − 0.17, P < 0.01) symptoms. Satisfaction with care coordination (B = − 0.48, P = 0.04) and speed with which symptoms are treated (B = − 0.44, P = 0.04) correlated with shorter LOS. Conclusions : Hospitalized patients with cancer report high care satisfaction, which correlates with older age and admission to a dedicated oncology service. Significant associations among higher care satisfaction, lower symptom burden, and shorter hospital LOS highlight the importance of improving symptom management and care coordination in this population.