Impacts of multidisciplinary meeting case discussion on palliative care referral and end‐of‐life care in lung cancer: A retrospective observational study

2021 ◽  
Author(s):  
Krita Sridharan ◽  
Eldho Paul ◽  
Robert G Stirling ◽  
Chi Li
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
Observational Study ◽  
End Of Life ◽  
End Of Life Care ◽  
Retrospective Observational Study ◽  
Life Care ◽  
Case Discussion ◽  
Multidisciplinary Meeting

scholarly journals Impact of comprehensive hospice palliative care on end-of-life care: a propensity-score–matched retrospective observational study

CMAJ Open ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. E197-E202 ◽  
Author(s):  
Michael S.C. Conlon ◽  
Joseph M. Caswell ◽  
Andrew Knight ◽  
Barbara Ballantyne ◽  
Stacey A. Santi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Propensity Score ◽  
Observational Study ◽  
End Of Life ◽  
End Of Life Care ◽  
Retrospective Observational Study ◽  
Life Care ◽  
Hospice Palliative Care

scholarly journals End‐of‐life care in an Australian acute hospital: a retrospective observational study

2019 ◽  
Vol 49 (11) ◽  
pp. 1400-1405 ◽  
Author(s):  
Ninya Maubach ◽  
Monique Batten ◽  
Scott Jones ◽  
Judy Chen ◽  
Brett Scholz ◽  
...  
Keyword(s):  
Observational Study ◽  
End Of Life ◽  
End Of Life Care ◽  
Acute Hospital ◽  
Retrospective Observational Study ◽  
Life Care

scholarly journals Inappropriate end-of-life cancer care in a generalist and specialist palliative care model: a nationwide retrospective population-based observational study

2020 ◽  
pp. bmjspcare-2020-002302
Author(s):  
Manon S Boddaert ◽  
Chantal Pereira ◽  
Jeroen Adema ◽  
Kris C P Vissers ◽  
Yvette M van der Linden ◽  
...  
Keyword(s):  
Palliative Care ◽  
Observational Study ◽  
End Of Life ◽  
End Of Life Care ◽  
Population Based ◽  
Exposure Group ◽  
Life Care ◽  
Patients With Cancer ◽  
Timely Access ◽  
The Impact

ObjectivesTo evaluate the impact of provision and timing of palliative care (PC) on potentially inappropriate end-of-life care to patients with cancer in a mixed generalist—specialist PC model.MethodA retrospective population-based observational study using a national administrative health insurance database. All 43 067 adults in the Netherlands, who were diagnosed with or treated for cancer during the year preceding their death in 2017, were included. Main exposure was either generalist or specialist PC initiated >30 days before death (n=16 967). Outcomes were measured over the last 30 days of life, using quality indicators for potentially inappropriate end-of-life care.ResultsIn total, 14 504 patients (34%) experienced potentially inappropriate end-of-life care; 2732 were provided with PC >30 days before death (exposure group) and 11 772 received no PC or ≤30 days before death (non-exposure group) (16% vs 45%, p<0.001). Most patients received generalist PC (88%). Patients provided with PC >30 days before death were 5 times less likely to experience potentially inappropriate end-of-life care (adjusted OR (AOR) 0.20; (95% CI 0.15 to 0.26)) than those with no PC or PC in the last 30 days. Both early (>90 days) and late (>30 and≤90 days) PC initiation had lower odds for potentially inappropriate end-of-life care (AOR 0.23 and 0.19, respectively).ConclusionTimely access to PC in a mixed generalist—specialist PC model significantly decreases the likelihood of potentially inappropriate end-of-life care for patients with cancer. Generalist PC can play a substantial role.

Trends in aggressive care at the end-of-life for stage IV lung cancer patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6614-6614
Author(s):  
Chebli Mrad ◽  
Marwan S Abougergi ◽  
Robert Michael Daly
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Life Care ◽  
Metastatic Lung Cancer ◽  
Lung Cancer Patients ◽  
Metastatic Lung ◽  
Aggressive Care

6614 Background: Prior studies have demonstrated that high-intensity end-of-life care improves neither survival nor quality of life for cancer patients. The National Quality Forum endorses dying from cancer in an acute care setting, ICU admission in the last 30 days of life, and chemotherapy in the last 14 days of life as markers of poor quality care. Methods: Discharge data from the National Inpatient Sample database was analyzed for 3,030,866 acute care hospitalizations of metastatic lung cancer patients between 1998 and 2014. Longitudinal analysis was conducted to determine trends in aggressive care at the end-of-life and multivariate logistic regression was performed to determine associations with age, race, region, hospital characteristics, and aggressive care. Results: In-hospital mortality for metastatic lung cancer patients decreased from 17% to 11%. Among terminal hospitalizations, utilization of radiation therapy and chemotherapy decreased from 4.6% to 3.0% and from 4.8% to 3.0%, respectively. However, the proportion admitted to the ICU increased from 13.3% to 27.9% and invasive procedures increased from 1.2% to 2.0%. Reflecting this aggressive end-of-life care, mean total charges for a terminal hospitalization rose from $29,386 to $72,469, adjusted for inflation. Among patients who died in the inpatient setting, the ICU stay translated into higher total costs (+$16,962, CI: $15,859 to $18,064) compared to patients who avoided the ICU. Promisingly, palliative care encounters for terminal hospitalizations increased during this period from 8.7% to 53.0% and was correlated with a decrease in inpatient chemotherapy (OR = 0.56, CI: 0.47 to 0.68), radiotherapy (OR = 0.77, CI: 0.65 to 0.92), and ICU admissions (OR = 0.48, CI: 0.45 to 0.53) but had only a modest impact on terminal hospitalization cost (-$2,992, CI: -$3,710 to -$2,275). Multivariable analysis showed variation by patient and hospital characteristics in aggressive care utilization. Conclusions: Among patients with metastatic lung cancer there has been a substantial increase in ICU use during terminal hospitalizations, resulting in high cost for the health care system. Inpatient palliative care has the potential to reduce aggressive end-of-life interventions.

scholarly journals End-of-Life Care for Hospitalized Patients with Lung Cancer: Utilization of a Palliative Care Service

2010 ◽  
Vol 13 (10) ◽  
pp. 1261-1266 ◽  
Author(s):  
Barbara Reville ◽  
Marshal N. Miller ◽  
Richard W. Toner ◽  
JoAnne Reifsnyder
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Care Service ◽  
Palliative Care Service ◽  
Hospitalized Patients ◽  
Life Care
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