Self-selection in a population-based cohort study: impact on health service use and survival for bowel and lung cancer assessed using data linkage

IntroductionEpilepsy places a large burden on health systems, with hospitalisations for seizures alone occurring more frequently than those related to diabetes. However, the cost of epilepsy to the Australian health system is not well understood. The primary aim of this study is to quantify the health service use and cost of epilepsy in Queensland, Australia. Secondary aims are to identify differences in health service use and cost across population and disease subgroups, and to explore the associations between health service use and common comorbidities.Methods and analysisThis project will use data linkage to identify the health service utilisation and costs associated with epilepsy. A base cohort of patients will be identified from the Queensland Hospital Admitted Patient Data Collection. We will select all patients admitted between 2014 and 2018 with a diagnosis classification related to epilepsy. Two comparison cohorts will also be identified. Retrospective hospital admissions data will be linked with emergency department presentations, clinical costing data, specialist outpatient and allied health occasions of service data and mortality data. The level of health service use in Queensland, and costs associated with this, will be quantified using descriptive statistics. Difference in health service costs between groups will be explored using logistic regression. Linear regression will be used to model the associations of interest. The analysis will adjust for confounders including age, sex, comorbidities, indigenous status, and remoteness.Ethics and disseminationEthical approval has been obtained through the QUT University Human Research Ethics Committee (1900000333). Permission to waive consent has been granted under the Public Health Act 2005, with approval provided by all relevant data custodians. Findings of the proposed research will be communicated through presentations at national and international conferences, presentations to key stakeholders and decision-makers, and publications in international peer-reviewed journals.

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Health service use among Manitobans with alcohol use disorder: a population-based matched cohort study

CMAJ Open ◽

10.9778/cmajo.20200124 ◽

2020 ◽

Vol 8 (4) ◽

pp. E762-E771

Author(s):

James M. Bolton ◽

Christine Leong ◽

Okechukwu Ekuma ◽

Heather J. Prior ◽

Geoffrey Konrad ◽

...

Keyword(s):

Cohort Study ◽

Alcohol Use ◽

Health Service ◽

Alcohol Use Disorder ◽

Service Use ◽

Population Based ◽

Health Service Use ◽

Matched Cohort ◽

Matched Cohort Study

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68PD SELF-SELECTION EFFECT IN LUNG CANCER SCREENING OF SMOKERS. A 9.5-YEAR POPULATION-BASED COHORT STUDY IN VARESE – ITALY

Lung Cancer ◽

10.1016/s0169-5002(09)70191-6 ◽

2009 ◽

Vol 64 ◽

pp. S33-S34

Author(s):

L. Dominioni ◽

A. Imperatori ◽

A. Poli ◽

M. Paolucci ◽

F. Sessa ◽

...

Keyword(s):

Lung Cancer ◽

Cohort Study ◽

Cancer Screening ◽

Selection Effect ◽

Lung Cancer Screening ◽

Population Based ◽

Self Selection

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Acute mental health service use is increased in rheumatoid arthritis and ankylosing spondylitis: a population-based cohort study

Therapeutic Advances in Musculoskeletal Disease ◽

10.1177/1759720x20921710 ◽

2020 ◽

Vol 12 ◽

pp. 1759720X2092171

Author(s):

Bindee Kuriya ◽

Vivian Tia ◽

Jin Luo ◽

Jessica Widdifield ◽

Simone Vigod ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Mental Health ◽

Ankylosing Spondylitis ◽

Health Service ◽

Service Use ◽

Population Based ◽

System Level ◽

Health Service Use ◽

Increased Risk ◽

Ed Visits

Background: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with mental illness. Whether acute mental health (MH) service utilization (i.e. emergency visits or hospitalizations) is increased in RA or AS is not known. Methods: Two population-based cohorts were created where individuals with RA ( n = 53,240) or AS ( n = 13,964) were each matched by age, sex, and year to unaffected comparators (2002–2016). Incidence rates per 1000 person-years (PY) were calculated for a first MH emergency department (ED) presentation or MH hospitalization. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated, adjusting for demographic, clinical, and health service use variables. Results: Individuals with RA had higher rates of ED visits [6.59/1000 person-years (PY) versus 4.39/1000 PY in comparators] and hospitalizations for MH (3.11/1000 PY versus 1.80/1000 PY in comparators). Higher rates of ED visits (7.92/1000 PY versus 5.62/1000 PY in comparators) and hospitalizations (3.03/1000 PY versus 1.94/1000 PY in comparators) were also observed in AS. Overall, RA was associated with a 34% increased risk for MH hospitalization (HR 1.34, 95% CI 1.22–1.47) and AS was associated with a 36% increased risk of hospitalization (HR 1.36, 95% CI 1.12–1.63). The risk of ED presentation was attenuated, but remained significant, after adjustment in both RA (HR 1.08, 95% CI 1.01–1.15) and AS (HR 1.14, 95% CI 1.02–1.28). Conclusions: RA and AS are both independently associated with a higher rate and risk of acute ED presentations and hospitalizations for mental health conditions. These findings underscore the need for routine evaluation of MH as part of the management of chronic inflammatory arthritis. Additional research is needed to identify the underlying individual characteristics, as well as system-level variation, which may explain these differences, and to help plan interventions to make MH service use more responsive to the needs of individuals living with RA and AS.

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