Elsevier

Annals of Oncology

Volume 20, Issue 2, February 2009, Pages 343-348
Annals of Oncology

original articles
quality of life/supportive care/palliative care
Trends in quality of end-of-life care for Taiwanese cancer patients who died in 2000–2006

https://doi.org/10.1093/annonc/mdn602Get rights and content
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Abstract

Background

Quality of end-of-life care received by cancer patients has never been explored in an entire Asian country for all ages and cancer groups.

Patients and methods

Retrospective cohort study to examine trends in quality of end-of-life care among a cohort of 242 530 Taiwanese cancer patients who died in 2000–2006.

Results

In the last month of life, cancer care tended to become increasingly aggressive as shown by (i) intensive use of chemotherapy (15.45%–17.28%), (ii) frequent emergency room visits (15.69%–20.99%) and >14-day hospital stays (41.48%–46.20%), (iii) admissions to intensive care units (10.04%–12.41%), and (iv) hospital deaths (59.11%–65.40%). Use of cardiopulmonary resuscitation (13.09%–8.41%), intubation (26.01%–21.07%), and mechanical ventilation (27.46%–27.05%) decreased, whereas use of hospice services increased considerably (7.34%–16.83%). Among those receiving hospice services, rates of referrals to hospice services in the last 3 days of life decreased from 17.88% to 17.13% but remained steady after adjusting for selected covariates.

Conclusions

The quality of end-of-life care for Taiwanese cancer decedents was substantially inferior to that previously reported and to that recommended as benchmarks for not providing overly aggressive care near the end of life.

Keywords

administrative databases analysis
aggressiveness of care near the end of life
population-based study
quality of end-of-life care

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