Comparison of physician-delivered models of virtual and home-based in-person care for adults in the last 90 days of life with cancer and terminal noncancer illness during the COVID-19 pandemic.

Autor: Akhter, Rabia, Stukel, Thérèse A., Chung, Hannah, Bell, Chaim M., Detsky, Allan S., Downar, James, Isenberg, Sarina R., Lapp, John, Mokhtarnia, Media, Stall, Nathan, Tanuseputro, Peter, Quinn, Kieran L.
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Zdroj: PLoS ONE; 11/27/2024, Vol. 19 Issue 11, p1-14, 14p
Abstrakt: Objective: To measure the association between types of serious illness and the use of different physician-delivered care models near the EOL during the COVID-19 pandemic. Design, setting and participants: Population-based cohort study using health administrative datasets in Ontario, Canada, for adults aged ≥18 years in their last 90 days of life who died of cancer or terminal noncancer illness and received physician-delivered care models near the end-of-life between March 14, 2020 and January 24, 2022. Exposure: The type of serious illness (cancer or terminal noncancer illness). Main outcome: Physician-delivered care models for adults in the last 90 days of life (exclusively virtual, exclusively home-based in-person, or mixed). Results: The study included 75,930 adults (median age 78 years, 49% female, cancer n = 58,894 [78%], noncancer illness n = 17,036 [22%]). A higher proportion of people with cancer (39.3%) received mixed model of care compared to those with noncancer illnesses (chronic organ failure 24.4%, dementia 37.9%, multimorbidity 28%). Compared to people with cancer, people with chronic organ failure (adjusted odds ratio [aOR], 1.61, 95% CI: 1.54 to 1.68) and those with multimorbidity ([aOR], 1.49, 95% CI: 1.39 to 1.59) had a higher odds of receiving virtual care than a mixed model of care. People with dementia had a higher odds of home-based in-person care than a mixed model of care ([aOR], 1.47, 95% CI 1.27, 1.71) and virtual care ([aOR], 1.40, 95% CI 1.20–1.62) compared to people with cancer. Conclusion: A person's type of serious illness was associated with different care models near the end-of-life. This study demonstrates persistent disease-specific differences in care delivery or possibly the tailoring of models of care in the last 90 days of life based on a person's specific care needs. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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