Objective
Mental health comorbidity adversely affects outcomes in nonpsychiatric conditions, including cancer. In this context, study examined the association between virtual care use and unplanned health service use among cancer patients with and without mental health comorbidity.
Sample and Setting
A retrospective cohort study was conducted on 78,323 adults diagnosed with cancer who accessed outpatient oncology services in Queensland and Victoria between 1 January 2018 and 31 December 2020. Among these, 5,212 individuals were identified as having a mental health-related comorbidity using hospitalised diagnoses. Non-admitted patient (NAP) records were linked to emergency department, inpatient, cancer registry, and mortality datasets.
Procedure
The study cohort was stratified into two groups based on mental health comorbidity: patients with both cancer and a mental health diagnosis, and patients with cancer only. Within each group, multivariable logistic regression models estimated the odds of unplanned ED visits, all-cause hospitalisations, cancer-related hospitalisations, and mental health-related hospitalisations (comorbid group only). Models compared virtual-care users to non-users, adjusting for potential confounders.
Results
Virtual care use was associated with higher odds of unplanned emergency department visits and all-cause hospitalisations across all cancer patients compared to in-person care. The associations were higher among patients with comorbid mental health conditions (ED: OR = 2.02; 95% CI, 1.93–2.11) compared to patients without mental health conditions (OR = 1.58; 95% CI, 1.45–1.72). Similarly, for unplanned all-cause hospitalisations, the odds were higher in the comorbid mental health cohort (OR = 1.56; 95% CI, 1.45–1.69) than in the cancer-only cohort (OR = 1.18; 95% CI, 1.09–1.27).
Conclusion and Clinical Implications
Virtual outpatient oncology care is linked to greater unplanned health service use, particularly among patients with comorbid mental health conditions. The findings highlight the need to better understand how incorporating virtual care can effectively support patients with complex needs, including those with comorbid mental health conditions.