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Article: End-of-Life Health Care Utilization Between Chronic Obstructive Pulmonary Disease and Lung Cancer Patients

TitleEnd-of-Life Health Care Utilization Between Chronic Obstructive Pulmonary Disease and Lung Cancer Patients
Authors
KeywordsEnd-of-life care
COPD
Lung cancer
Issue Date2019
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jpainsymman
Citation
Journal of Pain and Symptom Management, 2019, v. 57 n. 5, p. 933-943 How to Cite?
AbstractContext: At the end of life, chronic obstructive pulmonary disease (COPD) and lung cancer (LC) patients exhibit similar symptoms; however, a large-scale study comparing end-of-life health care utilization between these two groups has not been conducted in East Asia. Objectives: To explore and compare end-of-life resource use during the last six months before death between COPD and LC patients. Methods: Using data from the Taiwan National Health Insurance Research Database, we conducted a nationwide retrospective cohort study in COPD (n = 8640) and LC (n = 3377) patients who died between 1997 and 2013. Results: The COPD decedents were more likely to be admitted to intensive care units (57.59% vs 29.82%), to have longer intensive care unit stays (17.59 vs 9.93 days), and to undergo intensive procedures than the LC decedents during their last six months; they were less likely to receive inpatient (3.32% vs 18.24%) or home-based palliative care (0.84% vs 8.17%) and supportive procedures than the LC decedents during their last six months. The average total medical cost during the last six months was approximately 18.42% higher for the COPD decedents than for the LC decedents. Conclusion: Higher intensive health care resource use, including intensive procedure use, at the end of life suggests a focus on prolonging life in COPD patients; it also indicates an unmet demand for palliative care in these patients. Avoiding potentially inappropriate care and improving end-of-life care quality by providing palliative care to COPD patients are necessary.
Persistent Identifierhttp://hdl.handle.net/10722/275862
ISSN
2017 Impact Factor: 3.249
2015 SCImago Journal Rankings: 1.514
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKuo, L-
dc.contributor.authorChen, J-
dc.contributor.authorLee, C-
dc.contributor.authorTsai, C-
dc.contributor.authorLin, C-
dc.date.accessioned2019-09-10T02:51:10Z-
dc.date.available2019-09-10T02:51:10Z-
dc.date.issued2019-
dc.identifier.citationJournal of Pain and Symptom Management, 2019, v. 57 n. 5, p. 933-943-
dc.identifier.issn0885-3924-
dc.identifier.urihttp://hdl.handle.net/10722/275862-
dc.description.abstractContext: At the end of life, chronic obstructive pulmonary disease (COPD) and lung cancer (LC) patients exhibit similar symptoms; however, a large-scale study comparing end-of-life health care utilization between these two groups has not been conducted in East Asia. Objectives: To explore and compare end-of-life resource use during the last six months before death between COPD and LC patients. Methods: Using data from the Taiwan National Health Insurance Research Database, we conducted a nationwide retrospective cohort study in COPD (n = 8640) and LC (n = 3377) patients who died between 1997 and 2013. Results: The COPD decedents were more likely to be admitted to intensive care units (57.59% vs 29.82%), to have longer intensive care unit stays (17.59 vs 9.93 days), and to undergo intensive procedures than the LC decedents during their last six months; they were less likely to receive inpatient (3.32% vs 18.24%) or home-based palliative care (0.84% vs 8.17%) and supportive procedures than the LC decedents during their last six months. The average total medical cost during the last six months was approximately 18.42% higher for the COPD decedents than for the LC decedents. Conclusion: Higher intensive health care resource use, including intensive procedure use, at the end of life suggests a focus on prolonging life in COPD patients; it also indicates an unmet demand for palliative care in these patients. Avoiding potentially inappropriate care and improving end-of-life care quality by providing palliative care to COPD patients are necessary.-
dc.languageeng-
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jpainsymman-
dc.relation.ispartofJournal of Pain and Symptom Management-
dc.subjectEnd-of-life care-
dc.subjectCOPD-
dc.subjectLung cancer-
dc.titleEnd-of-Life Health Care Utilization Between Chronic Obstructive Pulmonary Disease and Lung Cancer Patients-
dc.typeArticle-
dc.identifier.emailLin, C: cclin@hku.hk-
dc.identifier.authorityLin, C=rp02265-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jpainsymman.2019.01.011-
dc.identifier.pmid30708124-
dc.identifier.scopuseid_2-s2.0-85062811059-
dc.identifier.hkuros304298-
dc.identifier.volume57-
dc.identifier.issue5-
dc.identifier.spage933-
dc.identifier.epage943-
dc.identifier.isiWOS:000465123100011-
dc.publisher.placeUnited States-

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