Introduction: Health expenditure is increasing in Australia yet limited data exists on which populations have the highest use of health services. As people with cancer are likely to have increased use of health services due to treatment and supportive care, this study explored the patterns of medical service utilisation in people with cancer compared to those without.
Methods: Data of respondents aged ≥25 years from two Australian National Health Surveys 2014-15 and 2020-21 were linked to medical services records from the Medicare Benefits Schedule through the Person Level Integrated Data Asset (PLIDA). 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.
Results: 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 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. Using LCA, three distinct patterns of medical service use were identified, with one group of cancer survivors tending to be older, having a higher burden of comorbidities and polypharmacy, and showing complex needs for multiple types of services.
Conclusion: Older adults with cancer used medical services significantly more than people without cancer. 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 this population with highest usage.