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VARIATION IN THE CARE OF BLOOD AND BOWEL CANCER PATIENTS AT THE END OF LIFE: FEASIBILITY OF USING HOSPITAL EPISODE STATISTICS TO EXAMINE NATIONAL PATTERNS
  1. E V Kane1,
  2. E Morris2,
  3. E Bolton2,
  4. J Wilkinson2,3,
  5. D Howell1,
  6. M Johnson4,
  7. U McLeod4 and
  8. S E Oliver1,2,4
  1. 1Department of Health Sciences, University of York
  2. 2Northern and Yorkshire Cancer Registration and Information Service, St James's University Hospital, Leeds
  3. 3North East Public Health Observatory, University of Durham
  4. 4Hull York Medical School, Universities of Hull and York

Abstract

Introduction People dying from haematological cancer are more likely to do so in hospital than is the case for other cancers. We are assessing the utility of data linkage to provide insights into this and other patterns in end of life care, contrasting these malignancies with colorectal cancer.

Aims and Methods To explore secondary care patterns in the last year of life, we assessed linkage between mortality data and Hospital Episode Statistics (HES) inpatient records. Deaths from haematological and colorectal cancers in England in 2008 were identified from national death registrations and linked to cancer registration and HES inpatient data. Sex, age and place of death distributions were compared.

Results Ninety percent of 9952 persons who died from haematological cancer and 85% of 13 040 persons who died from colorectal cancer were linked to hospital admissions in the last year of life. More men (55%) than women died from both these cancers and over 80% of deaths occurred in those aged over 65yrs. More haematological than colorectal cancer deaths occurred in hospital (64% vs 38%), and fewer at home (17% vs 28%) or in a hospice (10% vs 19%). Similar distributions by sex, age and place of death were found among persons with a hospital admission in the last year of life.

Conclusions Linkage of national mortality data to HES records was largely comprehensive and representative of all deaths from these cancers. This national linked dataset will support further exploration of differences in healthcare activity between these cancers at the end of life.

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