Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 145 No. 4950 (2015)

Use of inpatient rehabilitation for cancer patients in Switzerland: who undergoes cancer rehabilitation?

  • Maria Ture
  • Jürgen Barth
  • Felix Angst
  • André Aeschlimann
  • Ulrich Schnyder
  • Nic Zerkiebel
  • Josef Perseus
  • Christoph Renner
  • Patrick Imesch
  • Bruno Fuchs
  • Gerhard Frank Huber
  • Heinrich Walt
  • Chantal Martin-Soelch
  • Josef Jenewein
DOI
https://doi.org/10.4414/smw.2015.14214
Cite this as:
Swiss Med Wkly. 2015;145:w14214
Published
29.11.2015

Summary

QUESTION UNDER STUDY: Rehabilitation for cancer patients aims to reduce physical disability and mental distress resulting from the disease and its treatment. However, little is known about the use of cancer inpatient rehabilitation in Switzerland in relation to sociodemographic and medical characteristics. The main purpose of this study was to evaluate whether there are differences in sociodemographic and medical characteristics between patients who underwent inpatient rehabilitation (users) and those who did not (nonusers).

METHODS: A total of 238 cancer patients from the University Hospital Zurich were included. The sociodemographic and medical characteristics of inpatient rehabilitation users were assessed and compared with those of nonusers. We analysed the differences between inpatient rehabilitation users and nonusers.

RESULTS: Of the patients included, 101 (42.4%) used inpatient rehabilitation. They were less likely to be employed (p = 0.029), stayed longer in hospital (p <0.001), and were more likely to have semiprivate or private supplementary health insurance (p = 0.030) than nonusers. There were differences in cancer site (p = 0.001). Patients with tumours of the digestive organs or of the thoracic organs were more likely to use rehabilitation, whereas breast cancer patients were less likely to use it. Stratified analyses showed that male patients with semiprivate or private supplementary health insurance (p = 0.037), lower education (p = 0.039), and lower likelihood of employment (p = 0.051) were more likely to use rehabilitation. Women with an advanced tumour stage used inpatient rehabilitation more often (p = 0.012).

CONCLUSIONS: Findings show the influence of duration of hospitalisation, insurance type, cancer site, employment status, and gender on the use of inpatient cancer rehabilitation. The results indicate the need of structured standardised procedures for medical referral to be implemented based on screening.

References

  1. Oncosuisse. Nationales Krebsprogramm für die Schweiz 2011–2015. Bern: Rub Graf-Lehmann AG; 2011.
  2. NICER. Statistics 2014 [Internet]. [cited 2015 Mar 2]. Available from: http://www.nicer.org/NicerReportFiles2015/EN/report/atlas.html?&geog=0
  3. EUROCARE-5. Survival Analysis 2000-2007 [Internet]. [cited 2015 Mar 2]. Available from: https://w3.iss.it/site/eu5results/forms/SA0007.aspx
  4. Lorez M, Heusser R, Arndt V. Prevalence of cancer survivors in Switzerland. Schweizer Krebsbulletin. 2014;4:285–9.
  5. McCorkle R, Ercolano E, Lazenby M, Schulman-green D. Self-Management : Enabling and empowering patients living with cancer as a chronic illness. CA Cancer J Clin. 2011;50–62.
  6. Aziz NM, Rowland JH. Trends and advances in cancer survivorship research: challenge and opportunity. Semin Radiat Oncol. 2003;13(3):248–66.
  7. Dalton SO, Laursen TM, Ross L, Mortensen PB, Johansen C. Risk for hospitalization with depression after a cancer diagnosis: A nationwide, population-based study of cancer patients in Denmark from 1973 to 2003. J Clin Oncol. 2009;27(9):1440–5.
  8. Fialka-Moser V, Crevenna R, Korpan M, Quittan M. Cancer rehabilitation. Particularly with aspects on physical impairments. J Rehabil Med. 2003;35(4):153–62.
  9. Hudson MM, Mertens AC, Yasui Y, Hobbie W, Chen H, Gurney JG, et al. Health status of adult long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. JAMA. 2003;290(12):1583–92.
  10. Hewitt M, Greenfield S, Stovall E. From Cancer Patient to Cancer Survivor: Lost in Transition. Washington DC: National Academies Press; 2006.
  11. Hewitt M, Rowland JH, Yancik R. Cancer survivors in the United States: age, health, and disability. J Gerontol A Biol Sci Med Sci. 2003;58(1):82–91.
  12. Lehmann JF, DeLisa JA, Warren CG, DeLateur BJ, Bryant PL, Nicholson CG. Cancer rehabilitation: assessment of need, development, and evaluation of a model of care. Arch Phys Med Rehabil. 1978;59(9):410–9.
  13. Poppelreuter M, Weis J, Kulz AK, Tucha O, Lange KW, Bartsch HH. Cognitive dysfunction and subjective complaints of cancer patients: a cross-sectional study in a cancer rehabilitation centre. Eur J Cancer. 2004;40(1):43–9.
  14. Adler NE, Institute of Medicin. Cancer care for the whole patient: meeting psychosocial health needs. Washington DC: National Academies Press; 2008.
  15. Van Harten WH, van Noort O, Warmerdam R, Hendricks H, Seidel E. Assessment of rehabilitation needs in cancer patients. Int J Rehabil Res. 1998;21(3):247–57.
  16. Goodman A. Organic unity theory: the mind-body problem revisited. Am J Psychiatry. 1991;148(5):553–63.
  17. Cromes GF. Implementation of interdisciplinary rehabilitation. Rehab Couns Bull. 1978;21:230–7.
  18. Cheville AL. Cancer rehabilitation. Semin Oncol. 2005;32(2):219–24.
  19. World Health Organization. Disability prevention and rehabilitation: report of the WHO expert committee on disability prevention and rehabilitation. Technical Report Series 668. Geneva: WHO; 1981.
  20. Edwards AG, Hulbert-Williams N, Neal RD. Psychological interventions for women with metastatic breast cancer. Cochrane Database Syst Rev. 2008;(3):CD004253.
  21. Mewes JC, Steuten LMG, Ijzerman MJ, van Harten WH. Effectiveness of multidimensional cancer survivor rehabilitation and cost-effectiveness of cancer rehabilitation in general: a systematic review. Oncologist. 2012;17(12):1581–93.
  22. Riesenberg H, Lübbe AS. In-patient rehabilitation of lung cancer patients – a prospective study. Support Care Cancer. 2010;18(7):877–82.
  23. Teichmann J V. Oncological rehabilitation: evaluation of the efficiency of inpatient rehabilitation. Rehabil. 2002;41(1):53–63.
  24. Speck RM, Courneya KS, Mâsse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87–100.
  25. Weis J, Giesler JM. Rehabilitation for cancer patients. Recent Results Cancer Res. 2014;197:87–101.
  26. Bartsch HH, Zeiss T. Rehabilitation of patients with breast cancer. Rehabil. 2014;53(4):268–78.
  27. Koch U. Current developments in rehabilitation. Rehabil. 2000;39(6):315–6.
  28. Courneya KS, Mackey JR, Bell GJ, Jones LW, Field CJ, Fairey AS. Randomized controlled trial of exercise training in postmenopausal breast cancer survivors: Cardiopulmonary and quality of life outcomes. J Clin Oncol. 2003;21(9):1660–8.
  29. Daley AJ, Crank H, Saxton JM, Mutrie N, Coleman R, Roalfe A. Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol. 2007;25(13):1713–21.
  30. De Backer IC, van Breda E, Vreugdenhil A, Nijziel MR, Kester AD, Schep G. High-intensity strength training improves quality of life in cancer survivors. Acta Oncol. 2007;46(8):1143–51.
  31. Dimeo F, Schwartz S, Wesel N, Voigt a., Thiel E. Effects of an endurance and resistance exercise program on persistent cancer-related fatigue after treatment. Ann Oncol. 2008;19(8):1495–9.
  32. Cole RP, Scialla SJ, Bednarz L. Functional recovery in cancer rehabilitation. Arch Phys Med Rehabil. 2000;81(5):623–7.
  33. Guo Y, Shin KY, Hainley S, Bruera E, Palmer JL. Inpatient rehabilitation improved functional status in asthenic patients with solid and hematologic malignancies. Am J Phys Med Rehabil. 2011;90(4):265–71.
  34. Shin KY, Guo Y, Konzen B, Fu J, Yadav R, Bruera E. Inpatient cancer rehabilitation: the experience of a national comprehensive cancer center. Am J Phys Med Rehabil. 2011;90(5 Suppl 1):S63–8.
  35. Huang ME, Sliwa JA. Inpatient rehabilitation of patients with cancer: efficacy and treatment considerations. PM R. 2011;3(8):746–57.
  36. Spruit M a, Janssen PP, Willemsen SCP, Hochstenbag MMH, Wouters EFM. Exercise capacity before and after an 8-week multidisciplinary inpatient rehabilitation program in lung cancer patients: a pilot study. Lung Cancer. 2006;52(2):257–60.
  37. Haaf H-G. Findings on the Effectiveness of Rehabilitation. Rehabil. 2005;44(5):e1–20.
  38. Paul K, Buschbacher R. Cancer rehabilitation: increasing awareness and removing barriers. Am J Phys Med Rehabil. 2011;90(5 Suppl 1):S1–4.
  39. Cheville AL, Kornblith AB, Basford JR. An examination of the causes for the underutilization of rehabilitation services among people with advanced cancer. Am J Phys Med RehabilJ Phys Med Rehabil. 2011;90(5 Suppl 1):S27–37.
  40. Hunter EG, Baltisberger J. Functional outcomes by age for inpatient cancer rehabilitation: A retrospective chart review. J Appl Gerontol. 2013;32(4):443–56.
  41. Alfano CM, Ganz P a., Rowland JH, Hahn EE. Cancer survivorship and cancer rehabilitation: Revitalizing the link. J Clin Oncol. 2012;30(9):904–6.
  42. Movsas SB, Chang VT, Tunkel RS, Shah V V, Ryan LS, Millis SR. Rehabilitation needs of an inpatient medical oncology unit. Arch Phys Med Rehabil. 2003;84(11):1642–6.
  43. Deutsche Rentenversicherung. Reha-Bericht 2013 [Internet]. [cited 2015 Mar 24]. Available from: http://www.deutsche-rentenversicherung.de/Allgemein/de/Inhalt/6_Wir_ueber_uns/03_fakten_und_zahlen/04_reha_jahresberichte/downloads_reha_jahresberichte/rehabericht_2013.html
  44. Bachmann-Mettler I, Rosemann T. Ambulante Onkologische Rehabilitation Case Management in onkologischer Rehabilitation [Internet]. [cited 2015 Apr 2]. Available from: https://assets.krebsliga.ch/downloads/schlussbericht_camon_kls_11112013.pdf
  45. Busato A, Widmer M, Matter P. Variation in incidence of orthopaedic surgery between populations with basic or basic plus supplementary health insurance in Switzerland. Swiss Med Wkly. 2011;141:1–7.
  46. Härter M, Reuter K, Aschenbrenner A, Schretzmann B, Marschner N, Hasenburg A, Weis J. Psychiatric disorders and associated factors in cancer: results of an interview study with patients in inpatient, rehabilitation and outpatient treatment. Eur J Cancer. 2001;37(11):1385–93.
  47. Geyer S, Schlamstedt-Jahn U. Are there social inequalities in the utilisation of oncological rehabilitation by breast cancer patients. Gesundheitswesen. 2012;74(2):71–8.
  48. Lehmann C, Beierlein V, Hagen-Aukamp C, Kerschgens C, Rhee M, Frühauf S, Otto J, Graefen M, Krüll A, Berger D, Koch U, Bergelt C. Psychosocial predictors of utilization of medical rehabilitation services among prostate cancer patients. Rehabil. 2012;51(3):160–70.
  49. Weis J, Moser MT BH. Goal-orientated evaluation of inpatient rehabilitation programs for women with breast cancer (ZESOR-study). In: Jäckel WH, Bengel J, Herdt J E, editor. Research in rehabilitation: Results from a research network in southwest Germany. Stuttgart: Schattauer; 2006.
  50. Deutsche Rentenversicherung Bund. Rehabilitation 2009. Statistik der Deutschen Rentenversicherung. Band 179. Berlin: Deutsche Rentenversicherung Bund; 2010.
  51. Husmann G, Kaatsch P, Katalinic A. Krebs in Deutschland. 2005/2006. Häufigkeiten und Trends. Berlin: Robert-Koch-Institut; 2010.
  52. Waldmann a, Lautz E, Hampe J, Schreiber S, Schafmayer C, Katalinic A. Utilization of inpatient rehabilitation of younger patients with colorectal neoplasms – results of the project “Popgen-colorectal cancer.” Rehabil. 2007;46(6):349–55.
  53. Weis J, Moser MT, Bartsch HH. Zielorientierte Evaluation stationärer onkologischer Rehabilitationsmaßnahmen ZESOR -Studie [Internet]. [cited 2015 Mar 24]. Available from: http://forschung.deutsche-rentenversicherung.de/ForschPortalWeb/rehaDoc.pdf?rehaid=5f5eb3b5f78bf136c1256e9b002f82b6
  54. Bürger W, Morfeld M. Are there class-specific disadvantages in utilization of medical rehabilitation? Rehabilitation. 1999;38(Suppl 2):S134–41.
  55. ANQ-Vorstand. Nationaler Messplan Rehabilitation: Umsetzungskonzept [Internet]. [cited 2015 Mar 26]. Available from: http://www.anq.ch/fileadmin/redaktion/deutsch/20121024_Reha_Umsetzungskonzeption_20_Kurzversion_D_OF.pdf
  56. Bundesamt für Statistik. Medienmitteilung [Internet]. 2012 [cited 2015 Mar 19]. Available from: http://www.bfs.admin.ch/bfs/portal/de/index.html
  57. Klinik Susenberg. Zahlen [Internet]. [cited 2015 Mar 19]. Available from: http://www.susenbergklinik.ch/ueber-uns/zahlen/
  58. Gesundheitsdepartement Kanton St. Gallen. Spitalplanung Rehabilitation 2014. Versorgungsbericht [Internet]. [cited 2015 Mar 19]. Available from: http://www.sg.ch/home/gesundheit/gesundheitsversorgung/spitalliste/_jcr_content/Par/downloadlist/DownloadListPar/download.ocFile/Versorgungsbericht_Rehabilitation.pdf
  59. Krebsregister der Kantone Zürich und Zug. Jahresbericht 2012 [Internet]. [cited 2015 Aug 3]. Available from: http://www.krebsregister.usz.ch/fachwissen/Documents/Krebsregister_Jahresbericht_2012.pdf
  60. Kessler, J., Markowitsch, H. J., Denzler P. Mini-Mental-Status-Test (MMST). Göttingen: Beltz Test GmbH; 2000.
  61. International Classification of Functioning, Disability and Health (ICF) [Internet]. [cited 2015 Aug 3]. Available from: http://www.who.int/classifications/icf/en/
  62. Sobin LH, Gospodarowicz M, Wittekind C. TNM classification of malignant tumours. 7th ed. Oxford: Wiley-Blackwell; 2009.
  63. WHO/IARC Classification of Tumours – Fourth Edition [Internet]. [cited 2015 Mar 24]. Available from: http://www.iarc.fr/en/publications/list/bb/
  64. Klinik Schloss Mammern. Zahlen & Fakten [Internet]. [cited 2015 Mar 22]. Available from: http://www.klinik-schloss-mammern.ch/de/zahlen_fakten.61
  65. Reha Chrischona. Jahresbericht Reha Chrischona 2013 [Internet]. [cited 2015 Mar 19]. Available from: http://www.reha.buespi.ch/files/G8KZCEI/Jahresbericht-Reha-Chrischona-2013
  66. Hensel M, Egerer G, Schneeweiss a., Goldschmidt H, Ho a. D. Quality of life and rehabilitation in social and professional life after autologous stem cell transplantation. Ann Oncol. 2002;13(2):209–17.
  67. Gudbergsson SB, Fossa SD, Dahl AA. A study of work changes due to cancer in tumor-free primary-treated cancer patients. A NOCWO study. Support Care Cancer. 2008;16(10):1163–71.
  68. Peteet JR. Cancer and the meaning of work. Gen Hosp Psychiatry. 2000;22(3):200–5.
  69. Gray RE, Fitch M, Phillips C, Labrecque M, Fergus K. To tell or not to tell: Patterns of disclosure among men with prostate cancer. Psychooncology. 2000;9(4):273–82.
  70. Kinsinger DP, Penedo FJ, Antoni MH, Dahn JR, Lechner SC, Schneiderman N. Psychosocial and sociodemographic correlates of benefit-finding in men treated for loclized prostate cancer. Psychooncology. 2006;15(11):954–61.
  71. Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol. 2011;77(2):109–30.
  72. Bürger W. Gibt es geschlechtsspezifische Benachteiligungen in der Inanspruchnahme von medizinischen Rehabilitationsmaßnahmen? In: Worringten U, Zwingmann C, editors. Rehabilitation weiblich – männlich Geschlechtsspezifische Rehabilitationsforschung. Weinheim: Juventa; 2001. p. 55–71.
  73. Lehmann C, Bergelt C, Welk H, Hagen-Aukamp C, Berger D, Koch U. Do outpatient and inpatient rehabilitation programs differ in applied interventions and success? An analysis of medical discharge summaries. Phys Medizin Rehabil Kurortmedizin. 2008;18(2):59–68.
  74. Bundesamt für Statistik. Bildungsstatistik 2013 [Internet]. [cited 2015 Mar 24]. Available from: http://www.bfs.admin.ch/bfs/portal/de/index/themen/15/01/key/blank/01.html

Most read articles by the same author(s)

<< < 1 2 3 > >>