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End-of-life care for cancer patients in Japanese acute care hospitals: A nationwide retrospective administrative database survey
- Source :
- Japanese journal of clinical oncology. 48(10)
- Publication Year :
- 2018
-
Abstract
- Background End-of-life (EOL) cancer care in Japanese acute care hospitals has not been well described. Methods We aimed to assess the aggressiveness of EOL care and examine common treatments administered to cancer patients using a health administrative database. Subjects are adult cancer patients who died at acute care hospitals between April 2011 and March 2014. Data from the Japanese Diagnosis Procedure Combination database were analysed to measure the aggressiveness of care (chemotherapy, intensive care unit [ICU] admission and cardiopulmonary resuscitation [CPR]) and describe procedures and prescriptions administered in the last 14 and 30 days of life, disaggregated by hospital case volume: high, intermediate and low volumes. Results Of 248,978 cancer decedents, 170,024 died in high-, 70,231 in intermediate- and 8,723 in low-volume hospitals. Aggressive treatment in the last 14 days of life included chemotherapy (9.4%, 7.3%, and 5.4%, respectively), ICU admission (3.0%, 2.0%, and 2.4%) and CPR (5.8%, 6.4%, and 8.3%). Opioids were administered to 66.0%, 59.0% and 49.4% patients, while Palliative Care Team intervention was performed for 8.5%, 2.2% and 2.0% of patients, respectively in the last 30 days. In high-volume hospitals, radiotherapy and certified outpatient chemotherapy fees were more frequent. Catecholamines and hyperalimentation were more frequently administered in low-volume hospitals. Conclusion This is the first study to assess EOL care among Japanese acute care hospitals. More frequent use of chemotherapy at high-volume hospitals may reflect a well-established cancer treatment system. The approach for low-volume hospitals might improve the EOL care for all cancer patients in Japan.
- Subjects :
- Male
Cancer Research
medicine.medical_specialty
Palliative care
Databases, Factual
medicine.medical_treatment
law.invention
03 medical and health sciences
0302 clinical medicine
Japan
law
Acute care
Neoplasms
Surveys and Questionnaires
medicine
Humans
Radiology, Nuclear Medicine and imaging
030212 general & internal medicine
Cardiopulmonary resuscitation
Medical prescription
Aged
Retrospective Studies
Aged, 80 and over
Terminal Care
business.industry
Retrospective cohort study
General Medicine
Middle Aged
Chemotherapy regimen
Intensive care unit
Hospitals
Oncology
030220 oncology & carcinogenesis
Emergency medicine
Female
business
End-of-life care
Subjects
Details
- ISSN :
- 14653621
- Volume :
- 48
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Japanese journal of clinical oncology
- Accession number :
- edsair.doi.dedup.....331024ba119ef10bd37e361ca493fef5