Effect of Palliative Care on Aggressiveness of End-of-Life Care Among Patients With Advanced Cancer
| Autor: | Daniel P. Triplett, Lindsay Hwang, Alex K. Bryant, Eric Roeland, Andrew Bruggeman, Isabel J. Boero, Rayna K. Matsuno, James D. Murphy, Heidi N. Yeung, Wendi G LeBrett |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Palliative care Colorectal cancer Population MEDLINE Medical Oncology 03 medical and health sciences 0302 clinical medicine Neoplasms medicine Humans 030212 general & internal medicine Intensive care medicine education Aged Retrospective Studies Special Series: Palliative Care education.field_of_study Terminal Care Oncology (nursing) business.industry Health Policy Palliative Care Retrospective cohort study medicine.disease United States Death Hospitalization Hospice Care Oncology 030220 oncology & carcinogenesis Relative risk Cohort Emergency medicine Female business End-of-life care |
| Popis: | Purpose: Palliative care’s role in oncology has expanded, but its effect on aggressiveness of care at the end of life has not been characterized at the population level. Methods: This matched retrospective cohort study examined the effect of an encounter with palliative care on health-care use at the end of life among 6,580 Medicare beneficiaries with advanced prostate, breast, lung, or colorectal cancer. We compared health-care use before and after palliative care consultation to a matched nonpalliative care cohort. Results: The palliative care cohort had higher rates of health-care use in the 30 days before palliative care consultation compared with the nonpalliative cohort, with higher rates of hospitalization (risk ratio [RR], 3.33; 95% CI, 2.87 to 3.85), invasive procedures (RR, 1.75; 95% CI, 1.62 to 1.88), and chemotherapy administration (RR, 1.61; 95% CI, 1.45 to 1.78). The opposite pattern emerged in the interval from palliative care consultation through death, where the palliative care cohort had lower rates of hospitalization (RR, 0.53; 95% CI, 0.44-0.65), invasive procedures (RR, 0.52; 95% CI, 0.45 to 0.59), and chemotherapy administration (RR, 0.46; 95% CI, 0.39 to 0.53). Patients with earlier palliative care consultation in their disease course had larger absolute reductions in health-care use compared with those with palliative care consultation closer to the end of life. Conclusion: This population-based study found that palliative care substantially decreased health-care use among Medicare beneficiaries with advanced cancer. Given the increasing number of elderly patients with advanced cancer, this study emphasizes the importance of early integration of palliative care alongside standard oncologic care. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|