Associations of patient-reported care satisfaction with symptom burden and healthcare use in hospitalized patients with cancer

Background Hospitalized patients with cancer often experience a high symptom burden, which may impact care satisfaction and healthcare utilization. Methods We prospectively enrolled patients with cancer and unplanned hospitalizations from September 2014 to April 2017. Upon admission, we assessed patients’ care satisfaction (FAMCARE items: satisfaction with care coordination and speed with which symptoms are treated) and physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire-4 [PHQ-4]) symptoms. We used regression models to identify factors associated with care satisfaction and associations of satisfaction with symptom burden and hospital length of stay (LOS). Results Among 1,576 participants, most reported being “satisfied”/ “very satisfied” with care coordination (90%) and speed with which symptoms are treated (89%). Older age (coordination: B < 0.01, P = 0.02, speed: B = 0.01, P < 0.01) and admission to a dedicated oncology service ( B = 0.20, P < 0.01 for each) were associated with higher satisfaction. Higher satisfaction with care coordination was associated with lower ESAS-physical ( B = − 1.28, P < 0.01), ESAS-total ( B = − 2.73, P < 0.01), PHQ4-depression ( B = − 0.14, P = 0.02), and PHQ4-anxiety ( B = − 0.16, P < 0.01) symptoms. Higher satisfaction with speed with which symptoms are treated was associated with lower ESAS-physical ( B = − 1.32, P < 0.01), ESAS-total ( B = − 2.46, P < 0.01), PHQ4-depression ( B = − 0.14, P = 0.01), and PHQ4-anxiety ( B = − 0.17, P < 0.01) symptoms. Satisfaction with care coordination ( B = − 0.48, P = 0.04) and speed with which symptoms are treated ( B = − 0.44, P = 0.04) correlated with shorter LOS. Conclusions Hospitalized patients with cancer report high care satisfaction, which correlates with older age and admission to a dedicated oncology service. Significant associations among higher care satisfaction, lower symptom burden, and shorter hospital LOS highlight the importance of improving symptom management and care coordination in this population.