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Factors Associated With Aggressiveness of End-of-Life Care for Lung Cancer Patients and Associated Costs of Care.
- Source :
-
Clinical lung cancer [Clin Lung Cancer] 2021 May; Vol. 22 (3), pp. e320-e328. Date of Electronic Publication: 2020 May 23. - Publication Year :
- 2021
-
Abstract
- Background: Results of previous studies demonstrated that high-intensity end-of-life (EOL) care improves neither cancer patients' survival nor quality of life. Our objective was to assess the incidence of and factors associated with aggressiveness of care during the last 30 days of life (DOL) of lung cancer (LC) patients and the impacts of aggressiveness of care in EOL-care costs.<br />Patients and Methods: Using French national hospital database, all patients with LC who died between January 1, 2010, and December 31, 2011, or between January 1, 2015, and January 31, 2016, were included. EOL-care aggressiveness was assessed using the following criteria: chemotherapy administered within the last 14 DOL; more than one hospitalization within the last 30 DOL; admission to the intensive care unit within the last 30 DOL; and palliative care initiated < 3 days before death. Expenditures were limited to direct costs, from a health care payer's perspective.<br />Results: Among 79,746 adult LC patients identified; 57% had at least one indicator of EOL-care aggressiveness (49% repeated hospitalizations, 12% intensive care unit admissions, 9% chemotherapy, 5% palliative care). It increased significantly between the 2 periods (56% vs. 58%, P < .001). Young age, male sex, shorter time since diagnosis, comorbidities, no malnutrition, type of care facility other than general hospital, social deprivation, and low-density population were independently associated with having one or more indicator of aggressive EOL care. The mean EOL cost was €8152 ± 5117 per patient, but the cost was significantly higher for patients with at least one EOL-care aggressiveness criterion (€9480 vs. €6376, P < .001).<br />Conclusion: In France, a majority of LC patients had at least one criterion of aggressive EOL care that had a major economic impact on the health care system.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Databases, Factual
Female
France
Hospitalization economics
Hospitalization statistics & numerical data
Humans
Intensive Care Units economics
Intensive Care Units statistics & numerical data
Lung Neoplasms economics
Male
Middle Aged
Palliative Care economics
Retrospective Studies
Sex Factors
Terminal Care economics
Young Adult
Health Care Costs statistics & numerical data
Lung Neoplasms therapy
Palliative Care statistics & numerical data
Terminal Care methods
Subjects
Details
- Language :
- English
- ISSN :
- 1938-0690
- Volume :
- 22
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Clinical lung cancer
- Publication Type :
- Academic Journal
- Accession number :
- 32646653
- Full Text :
- https://doi.org/10.1016/j.cllc.2020.05.017