Latent class analysis identifies three subtypes of aggressive end-of-life care: A population-based study in Taiwan

2013 ◽  
Vol 49 (15) ◽  
pp. 3284-3291 ◽  
Author(s):  
Mei-Ling Chen ◽  
Yun-Yi Chen ◽  
Siew Tzuh Tang
Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1118
Author(s):  
Ralf Wagner ◽  
David Peterhoff ◽  
Stephanie Beileke ◽  
Felix Günther ◽  
Melanie Berr ◽  
...  

SARS-CoV-2 infection fatality ratios (IFR) remain controversially discussed with implications for political measures. The German county of Tirschenreuth suffered a severe SARS-CoV-2 outbreak in spring 2020, with particularly high case fatality ratio (CFR). To estimate seroprevalence, underreported infections, and IFR for the Tirschenreuth population aged ≥14 years in June/July 2020, we conducted a population-based study including home visits for the elderly, and analyzed 4203 participants for SARS-CoV-2 antibodies via three antibody tests. Latent class analysis yielded 8.6% standardized county-wide seroprevalence, a factor of underreported infections of 5.0, and 2.5% overall IFR. Seroprevalence was two-fold higher among medical workers and one third among current smokers with similar proportions of registered infections. While seroprevalence did not show an age-trend, the factor of underreported infections was 12.2 in the young versus 1.7 for ≥85-year-old. Age-specific IFRs were <0.5% below 60 years of age, 1.0% for age 60–69, and 13.2% for age 70+. Senior care homes accounted for 45% of COVID-19-related deaths, reflected by an IFR of 7.5% among individuals aged 70+ and an overall IFR of 1.4% when excluding senior care home residents from our computation. Our data underscore senior care home infections as key determinant of IFR additionally to age, insufficient targeted testing in the young, and the need for further investigations on behavioral or molecular causes of the fewer infections among current smokers.


2016 ◽  
Vol 25 (5) ◽  
pp. 1529-1536 ◽  
Author(s):  
Tzu-Lung Kuo ◽  
Ching-Heng Lin ◽  
Rong-San Jiang ◽  
Ting-Ting Yen ◽  
Chen-Chi Wang ◽  
...  

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 10521-10521
Author(s):  
Sumit Gupta ◽  
Rinku Sutradhar ◽  
Jason D Pole ◽  
Alisha Kassam ◽  
Adam Rapoport ◽  
...  

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e21518-e21518
Author(s):  
Emily E. Johnston ◽  
Elysia Marie Alvarez ◽  
Olga Saynina ◽  
Lee Sanders ◽  
Smita Bhatia ◽  
...  

2019 ◽  
pp. bmjspcare-2019-001782 ◽  
Author(s):  
Lou-Ching Kuo ◽  
Jung Jae Lee ◽  
Denise Shuk Ting Cheung ◽  
Ping-Jen Chen ◽  
Chia-Chin Lin

ObjectivesThe National Health Insurance programme started providing coverage for inpatient care in palliative care (PC) units of acute care hospitals in 2000; however, initially, only PC provided to patients with terminal cancer was covered. A PC policy that enabled PC reimbursement for patients with dementia was implemented in 2009. However, the association of this PC policy with end-of-life care remains unclear. The study aims to compare the association of the PC policy with end-of-life care between patients with dementia and patients with cancer during the last 6 months of their lives.MethodsWe analysed the claims data of 7396 patients dying with dementia (PDD) and 24 319 patients dying with cancer (PDC) during 1997–2013.ResultsAmong PDC, while the percentage of receiving PC increased from 3.6% in 1999 to 14.2% by the end of 2000 (adjusted OR (aOR)=4.07, 95% CI 2.70 to 6.13) and from 20.9% in 2010 to 41.0% in 2013 (aOR=1.40, 95% CI 1.33 to 1.47), vasopressor use decreased from 71.6% in 1999 to 35.5% in 2001 (aOR=0.90, 95% CI 0.82 to 0.98). Among PDD, PC use increased from 0.2% in 2009 to 4.9% in 2013 (aOR=2.05, 95% CI 1.60 to 2.63) and cardiopulmonary resuscitation use decreased from 17.6% in 2009 to 10.0% in 2013 (aOR=0.83, 95% CI 0.76 to 0.90).ConclusionsImplementation of the PC policy in Taiwan was associated with improved PC utilisation among patients with cancer and dementia, which may reduce unnecessary medical care procedures.


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