How to evaluate the requirement for rehabilitation for cancer inpatients?
Dr Chloé TARNAUDa, Dr Adélaïde MARQUERb, Prof Paul CALMELSc, Mrs Anne-Sophie DANGUINd
a Coordination SSR Rhône-Alpes, Hospices Civils de Lyon, b Coordination SSR et service MPR, CHU Grenoble, c Coordination SSR et service MPR, CHU de Saint-Etienne, d Agence régionale de Santé Rhône-Alpes
Objective. To characterize and measure the requirement for rehabilitation for cancer inpatients in order to improve cancer care pathways.
Population. Data was obtained from the regional hospital discharge database. We analyzed all hospital stays in acute care in 2013 for cancer inpatients living in Rhône-Alpes. These hospital stays were selected according to the algorithm of the National Institute of Cancer (regardless of hospitalization for medical supervision, screening, cancer antecedents, carcinoma in situ and benign tumors).
Methods. Professionals involved in cancer treatment where first asked to define situations that require rehabilitation after acute care. This clinical definition was applied to select corresponding hospital stays. We analyzed where they were discharged after acute care: in rehabilitation service, home care or home.
Results. Cancer inpatients’ needs for rehabilitation care after cancer surgery are allogeneic hematopoietic allograft, palliative care and medical complications during chemotherapy or radiotherapy treatment. The need for rehabilitation depends on social and environmental conditions of patients. Only serious surgery or allogeneic hematopoietic allograft always require rehabilitation care for specific rehabilitation.
Hospital discharge database: Among the 163,138 discharges of surviving cancer inpatients, 1,704 were related to a serious surgery or allogeneic hematopoietic allograft and should always be admitted in rehabilitation services. Only 31% were actually admitted in rehabilitation units, with discrepancies between hospitals, from 6% to 91%. For palliative care, (2,796 hospital stays), 27% were admitted in rehabilitation services and 22% in hospital at home with still large discrepancies according to areas.
Discussion. Characterizing requirement in rehabilitation for cancer after acute care hospitalization should contribute to elaborate cancer care pathway.
Keywords : Cancer, care pathway, inpatient database