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BMC Health Serv Res. 2017 Sep 12;17(1):644. doi: 10.1186/s12913-017-2594-4.

The utilization of formal and informal home care by older patients with cancer: a Belgian cohort study with two control groups.

Author information

Department of Oncology, ZNA Middelheim, Antwerp, Belgium.
Academic Centre for General Practice/ Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Department of Family Medicine, School CAPHRI, Maastricht University, Maastricht, The Netherlands.
Department of General Practice, University of Queensland, Brisbane, Australia.
Limburgs Oncologisch centrum, Jessa hospital, Hasselt, Belgium.
Department of General Medical Oncology, University hospitals Leuven, Leuven, Belgium.



The purpose of this paper is to analyse the utilization of formal and informal home care among older patients with cancer (OCP) and to compare this with middle-aged patients with cancer (MCP) and older patients without cancer (ONC). Additionally, we examined predictors of transitions towards formal care one year after a cancer diagnosis.


OCP and MCP had to be recruited within three months after a cancer diagnosis and have an estimated life expectancy over six months. ONC consisted of patients without known cancer, seen by the general practitioner. Formal and informal care were compared between the patient groups at baseline, i.e. shortly after a cancer diagnosis and changes in care were studied after one year.


A total of 844 patients were evaluable for formal care at baseline and 469 patients (56%) at follow-up. At baseline, about half of older adults and 18% of MCP used formal care, while about 85% of cancer patients and 57% ONC used informal care. Formal care increased for all groups after one year though not significantly in OCP. The amount of informal care only changed in MCP which decreased after one year. Cancer-related factors and changes in need factors predict a transition towards formal care after a cancer diagnosis.


A cancer diagnosis has a different impact on the use of formal and informal care than ageing as such. The first year after a cancer diagnosis is an important time to follow-up on the patients' needs for home care.


Cancer; Formal care; Home care; Informal care; Older patients

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