Patterns of health care use and expenditure during the last 6 months of life in Belgium: Differences between age categories in cancer and non-cancer patients

Gielen, Birgit; Remacle, Anne; Mertens, R

doi:10.1016/j.healthpol.2010.03.002

Cited by 65 publications

(69 citation statements)

References 30 publications

(42 reference statements)

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“…This result agrees with other studies, which report that older patients are less likely to receive hospital admissions and aggressive care at the end-oflife. 49,50 These data agree with those available in the literature regarding Italy, showing that the ratio of deaths at home in cancer patients raises significantly when the age increases. 51,52 These Italian data show an opposite tendency when compared with other countries.…”

Section: Discussionsupporting

confidence: 90%

Clinical and demographic factors associated to the place of death in advanced cancer patients assisted at home in Italy

Varani¹,

Dall’Olio²,

Messana³

et al. 2014

Progress in Palliative Care

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2015) Clinical and demographic factors associated to the place of death in advanced cancer patients assisted at home in Italy, Progress in Palliative Care, 23:2, 61-67, Introduction: Studies on the end of life have shown that patients with advanced cancer prefer to die at home, and their caregivers agree with this choice. However, many cancer patients still die in hospital. Few data are available for Southern Europe and, in particular, for Italy. This study examined the factors associated with the place of death in a cohort of Italian patients with advanced cancer who were assisted by a palliative home care team. Methods: We conducted a retrospective observational study to identify the association between place of death and clinical and demographic factors in a sample of 1374 patients. To analyze the factors associated with the place of death, we used univariate analyses by nonparametric tests and multinomial regression tests. Results: Five variables related to the place of death were significant in univariate analysis, but only three were retained significant in the multinomial regression test. The older patients died more frequently at home rather than in hospital (P < 0.05); a greater number of home visits by a physician in the last 30 days of home care was correlated with dying at home (P < 0.001), a greater number of hospitalizations during the last 30 days of home care was correlated with dying in hospital and in hospice (P < 0.001). Conclusions: The study shows that at the end of life the frequency of home visits by the palliative care physicians and a continuous at-home palliative service could favor dying at home in a cohort of cancer patients.

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Section: Discussionsupporting

confidence: 90%

Clinical and demographic factors associated to the place of death in advanced cancer patients assisted at home in Italy

Varani¹,

Dall’Olio²,

Messana³

et al. 2014

Progress in Palliative Care

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“…The importance of such research is evident, as disparities between countries, within countries and among different patient populations do matter on many levels such as quality of care issues [26,27,28,29,30,31], economical aspects [32,33,34] or shifts in the delivery of care over time [35]. …”

Section: Discussionmentioning

confidence: 99%

Cancer-Related Therapies at the End of Life in Hospitalized Cancer Patients from Four Swiss Cantons: SAKK 89/09

Matter-Walstra

Achermann²,

Rapold³

et al. 2014

Oncology

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The use of cancer-related therapies in cancer patients hospitalized at the end of life has increased in many countries over time. Given the scarcity of published Swiss data, the objective of this study was to evaluate the influence of hospital type and other factors on the delivery of health care during the last month before death. Claims data were used to assess health care utilization of cancer patients (identified by cancer registry data of four participating Swiss cantons) who deceased between 2006 and 2008. Primary endpoints were delivery of cancer-related therapies during the last 30 days before death. Multivariate logistic regression assessed the explanatory value of hospital type, patient and geographic characteristics. Of 3,809 identified cancer patients in the claims database, 2,086 patients dying from cancer were hospitalized during the last 30 days before death, generating 2,262 inpatient episodes. Anticancer drug therapy was given in 22.2% and radiotherapy in 11.7% of episodes. Besides age and cancer type, the canton of residence and hospital type showed independent, statistically significant associations with intensity of care, which was highest in university hospitals. These results should initiate a discussion among oncologists in Switzerland and may question the compliance with standard of care guidelines for terminal cancer patients. i 2014 S. Karger AG, Basel

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“…Moreover, past registrations and other outcomes of this registration of end-of-life care demonstrated good external validity when comparing the results to data from external resources. [39][40][41] Therefore, we consider the GP a reliable information provider, which justifies the use of these data.…”

Section: Bossuyt Et Almentioning

confidence: 99%

Is Individual Educational Level Related to End-of-Life Care Use? Results from a Nationwide Retrospective Cohort Study in Belgium

Bossuyt

Block

Cohen

et al. 2011

Journal of Palliative Medicine

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Background: Educational level has repeatedly been identified as an important determinant of access to health care, but little is known about its influence on end-of-life care use. Conclusions: Less well-educated people appear to be disadvantaged in terms of access to specialist palliative care services, and GP contacts at the end of life, suggesting a need for empowerment of less well-educated terminally ill people regarding specialist palliative and general end-of-life care use.

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Patterns of health care use and expenditure during the last 6 months of life in Belgium: Differences between age categories in cancer and non-cancer patients

Cited by 65 publications

References 30 publications

Clinical and demographic factors associated to the place of death in advanced cancer patients assisted at home in Italy

Clinical and demographic factors associated to the place of death in advanced cancer patients assisted at home in Italy

Cancer-Related Therapies at the End of Life in Hospitalized Cancer Patients from Four Swiss Cantons: SAKK 89/09

Is Individual Educational Level Related to End-of-Life Care Use? Results from a Nationwide Retrospective Cohort Study in Belgium

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