# Trajectory of Healthcare Contact Days for Veterans With Advanced Gastrointestinal Malignancy

## TL;DR

This study examines how often veterans with advanced gastrointestinal cancer interact with healthcare outside their homes, revealing patterns that could help improve care delivery.

## Contribution

The study introduces healthcare contact days as a practical measure to assess the burden of healthcare on patients' lives.

## Key findings

- Patients spent one-third of their days in healthcare contact.
- Healthcare contact days followed a U-shaped pattern over the course of illness.
- Contact days varied by clinical and sociodemographic factors.

## Abstract

How and where patients with advanced cancer facing limited survival spend their time is critical. Healthcare contact days (days with healthcare contact outside the home) offer a patient-centered and practical measure of how much of a person’s life is consumed by healthcare. We retrospectively analyzed contact days among decedent veterans with stage IV gastrointestinal cancer at the Minneapolis Veterans Affairs Healthcare System from 2010 to 2021. Among 468 decedents, the median overall survival was 4 months. Patients spent 1 in 3 days with healthcare contact. Over the course of illness, the percentage of contact days followed a “U-shaped” pattern, with an initial post-diagnosis peak, a lower middle trough, and an eventual rise as patients neared the end-of-life. Contact days varied by clinical factors and by sociodemographics. These data have important implications for improving care delivery, such as through care coordination and communicating expected burdens to and supporting patients and care partners.

Healthcare contact days (days with healthcare contact outside the home) offer a patient-centered and practical measure of how much of a person’s life is consumed by healthcare. This study retrospectively analyzed contact days among decedent veterans with stage IV gastrointestinal cancer. The results have important implications for improving care delivery.