Rates of medical service utilisation in people with and without cancer: an Australian cohort study

To explore the rates of medical service utilisation in people with and without cancer and the characteristics related to these rates.

Data of respondents aged ≥ 25 years from two Australian National Health Surveys 2014-2015 and 2020-2021 were linked to medical services records from the Medicare Benefits Schedule through the Person Level Integrated Data Asset. Comparisons by cancer status and age group (< 65 years versus ≥ 65 years) were conducted using negative binomial regression, while latent class analysis (LCA) was used to explore patterns of medical service use.

A total of 3636 people with cancer and 18,477 people without cancer were included. Relative to younger adults without cancer, the rate of any medical services was highest in older adults with cancer (adjusted rate ratio (aRR) = 1.43; 95% CI = 1.35-1.52). This was followed by younger adults with cancer (aRR = 1.31; 95% CI = 1.25-1.38) and older adults without cancer (aRR = 1.12; 95% CI = 1.06-1.18). Characteristics associated with a higher rate of medical services use were older age, being unemployed, having polypharmacy, and a higher number of health conditions in both cancer and non-cancer groups. LCA identified three distinct patterns of medical service use including an older group of cancer survivors with a higher burden of comorbidities and polypharmacy and complex needs for multiple types of services.

Cancer, age, multimorbidity and polypharmacy are strongly associated with medical service use. Research into predictors of health service use is crucial to inform the development of optimal approaches for care delivery, such as integrated onco-geriatric service models, tailored for populations with the highest usage.