File Download
  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Quality of end-of-life care of advanced cancer patients in mainland China—a retrospective cohort of 441 hospital-death in a public funded comprehensive hospital

TitleQuality of end-of-life care of advanced cancer patients in mainland China—a retrospective cohort of 441 hospital-death in a public funded comprehensive hospital
Authors
KeywordsAdvanced cancer
palliative care
end of life
chemotherapy
Do-Not-Resuscitate
Issue Date2020
PublisherAME Publishing Company. The Journal's web site is located at http://apm.amegroups.com/
Citation
Annals of Palliative Medicine, 2020, v. 9 n. 6, p. 4514-4521 How to Cite?
AbstractBackground: Shenzhen is a rapidly growing city in China with a population of over 11 million. The Hong Kong University-Shenzhen Hospital (HKU-SZH) was established in 2012 as a new model of publicly funded health care in mainland China. The clinical oncology center of the HKU-SZH was launched in 2013 which pledged to provide integrated palliative care for advanced cancer patients. This study aims to retrospectively analyze the quality of end-of-life care amongst patients with advanced cancer during their last hospitalization in the HKU-SZH. Methods: Consecutive patients with advanced solid cancer who passed away in the HKU-SZH from March 2013 to February 2016 were analyzed. Clinical information regarding cancer diagnosis, anticancer treatments, and the aggressiveness of the treatment during the last month of life was recorded. The discussions on the Do-Not-Resuscitate (DNR) order with family members were reviewed. Results: From March 2013 to February 2016, 441 patients with advanced solid cancer passed away in the HKU-SZH. A minority of them (9.3%, 41/441) received cytotoxic chemotherapy in the last month of life. Younger patients had high odds of receiving chemotherapy in their last month of life (OR 2.6, P=0.006). Those who received chemotherapy in their last month of life showed a trend of higher odds of admission to the intensive care unit (OR 2.94, P=0.08). The vast majority of family members / care providers (92.3%, 407/441) consented to the DNR order suggested by oncologists. The rate of DNR acceptance in this cohort was higher than previous reports from mainland China. Within HKU-SZH, the rate was higher in the oncology center than in other departments (OR 5.1, P<0.001). The use of chemotherapy in the last month of life did not associated with the acceptance of DNR (OR 1.3, P=0.23). Conclusions: The integrated oncology service of the new public hospital HKU-SZH achieved a satisfactory level of end-of-life care in patients with advanced cancer. Further studies are warranted to improve the early integration of palliative care service and to investigate the impact of palliative care on cost-effectiveness of oncology service.
Persistent Identifierhttp://hdl.handle.net/10722/290889
ISSN
2019 Impact Factor: 1.681
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLi, JS-
dc.contributor.authorLam, TC-
dc.contributor.authorJing, HM-
dc.contributor.authorChen, X-
dc.contributor.authorCao, MY-
dc.contributor.authorHuang, C-
dc.contributor.authorYang, L-
dc.contributor.authorXu, ZY-
dc.contributor.authorJiang, Y-
dc.contributor.authorLi, SS-
dc.contributor.authorChen, F-
dc.contributor.authorHan, Y-
dc.contributor.authorZhang, YS-
dc.contributor.authorLam, KO-
dc.contributor.authorLee, AWM-
dc.date.accessioned2020-11-02T05:48:32Z-
dc.date.available2020-11-02T05:48:32Z-
dc.date.issued2020-
dc.identifier.citationAnnals of Palliative Medicine, 2020, v. 9 n. 6, p. 4514-4521-
dc.identifier.issn2224-5820-
dc.identifier.urihttp://hdl.handle.net/10722/290889-
dc.description.abstractBackground: Shenzhen is a rapidly growing city in China with a population of over 11 million. The Hong Kong University-Shenzhen Hospital (HKU-SZH) was established in 2012 as a new model of publicly funded health care in mainland China. The clinical oncology center of the HKU-SZH was launched in 2013 which pledged to provide integrated palliative care for advanced cancer patients. This study aims to retrospectively analyze the quality of end-of-life care amongst patients with advanced cancer during their last hospitalization in the HKU-SZH. Methods: Consecutive patients with advanced solid cancer who passed away in the HKU-SZH from March 2013 to February 2016 were analyzed. Clinical information regarding cancer diagnosis, anticancer treatments, and the aggressiveness of the treatment during the last month of life was recorded. The discussions on the Do-Not-Resuscitate (DNR) order with family members were reviewed. Results: From March 2013 to February 2016, 441 patients with advanced solid cancer passed away in the HKU-SZH. A minority of them (9.3%, 41/441) received cytotoxic chemotherapy in the last month of life. Younger patients had high odds of receiving chemotherapy in their last month of life (OR 2.6, P=0.006). Those who received chemotherapy in their last month of life showed a trend of higher odds of admission to the intensive care unit (OR 2.94, P=0.08). The vast majority of family members / care providers (92.3%, 407/441) consented to the DNR order suggested by oncologists. The rate of DNR acceptance in this cohort was higher than previous reports from mainland China. Within HKU-SZH, the rate was higher in the oncology center than in other departments (OR 5.1, P<0.001). The use of chemotherapy in the last month of life did not associated with the acceptance of DNR (OR 1.3, P=0.23). Conclusions: The integrated oncology service of the new public hospital HKU-SZH achieved a satisfactory level of end-of-life care in patients with advanced cancer. Further studies are warranted to improve the early integration of palliative care service and to investigate the impact of palliative care on cost-effectiveness of oncology service.-
dc.languageeng-
dc.publisherAME Publishing Company. The Journal's web site is located at http://apm.amegroups.com/-
dc.relation.ispartofAnnals of Palliative Medicine-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAdvanced cancer-
dc.subjectpalliative care-
dc.subjectend of life-
dc.subjectchemotherapy-
dc.subjectDo-Not-Resuscitate-
dc.titleQuality of end-of-life care of advanced cancer patients in mainland China—a retrospective cohort of 441 hospital-death in a public funded comprehensive hospital-
dc.typeArticle-
dc.identifier.emailLam, TC: lamtc03@hku.hk-
dc.identifier.emailLam, KO: lamkaon@hku.hk-
dc.identifier.emailLee, AWM: awmlee@hkucc.hku.hk-
dc.identifier.authorityLam, TC=rp02128-
dc.identifier.authorityLam, KO=rp01501-
dc.identifier.authorityLee, AWM=rp02056-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.21037/apm-19-268-
dc.identifier.pmid32692211-
dc.identifier.scopuseid_2-s2.0-85096935236-
dc.identifier.hkuros317869-
dc.identifier.volume9-
dc.identifier.issue6-
dc.identifier.spage4514-
dc.identifier.epage4521-
dc.identifier.isiWOS:000595542800095-
dc.publisher.placeHong Kong-
dc.identifier.issnl2224-5820-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats