CHARACTERIZING REGIONAL VARIABILITY IN HEALTH RESOURCE UTILIZATION DURING THE DIAGNOSTIC PHASE OF LUNG CANCER ACROSS ONTARIO: A POPULATION-BASED ANALYSIS

TOPIC: Lung Cancer TYPE: Original Investigations PURPOSE: cancer (LC) is the leading cause of cancer-related mortality among Canadians. Significant differences in LC relative survival exist within Ontario (ON), though reasons for this require further elucidation. We aimed to characterize regional variability care through assessment health resource utilization (HRU) across ON regions by Local Health Integration Networks (LHIN) assess access and equity evaluate impact HRU on outcomes. METHODS: A retrospective population-based cohort study was conducted with ICES, an administrative database ON, from January 2007 - December 2017. Patients newly diagnosed were identified Registry, including if death. Data collected 90 days prior diagnosis until first treatment or up 120 after no received, included: number staging tests, biopsies, emergency department (ED) visits admissions. Through OHIP billing codes, specialty appointments internal medicine, pulmonology, thoracic surgery (TS), medical oncology, radiation palliative identified. Descriptive data unpaired t-tests are reported; a multivariate analysis progress. RESULTS: patients (n=70,749) underwent mean 3.20 investigations, which varied LHIN (range 2.52 3.61) stage (Stage I 2.97+/- 1.75 vs Stage IV 3.42+/- 1.88, p<0.001). disease more biopsies compared (mean all = 1.47, 1.86+/-1.17, 1.34+/-1.08, p<0.001), LHINs 1.25 1.61). ED common 0.92+/-1.56 1.68+/-1.67 visits, but hospital admissions occurred frequently (stage 0.94+/-0.79 0.91+/-0.87 admissions, p=0.001). The specialist between average 2.9 4.9 per patient, some remote areas seeing fewer specialists than urban regions. There significant types LHINs, pulmonology ranging 0.08 1.00 patient TS 0.21 1.62. Only 19.9% received smoking cessation counselling 15.1% 22.4% LHINs. CONCLUSIONS: varies ON. Further evaluation may explain variation CLINICAL IMPLICATIONS: knowledge gained project has potential identify disparities that contribute outcomes target improvement care. DISCLOSURES: disclosure file Micheal Brundage; No relevant relationships Genevieve Digby, source=Web Response Elizabeth Eisenhauer, Advisory Committee Member relationship AstraZeneca Precision Program Please note: 2017 present Added 05/14/2021 M. Diane Lougheed, Response, value=Honoraria Research Astra Zeneca Inc 2018-present value=Grant/Research Support GlaxoSmithKlein Speaker/Speaker's Bureau Canadian Thoracic Society 2019 Government 2019-present Monica Mullin, Chris Parker, Marlo Whitehead,