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Article: Trends and Changes in Intensive Care Use for Patients With Heart Failure in the Last Month of Life

TitleTrends and Changes in Intensive Care Use for Patients With Heart Failure in the Last Month of Life
Authors
Keywordsheart failure
hospice care
intensive care
palliative care
terminal care
Issue Date20-Mar-2024
PublisherSAGE Publications
Citation
INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2024, v. 61 How to Cite?
Abstract

A good death is a human right. Unfortunately, patients with chronic heart failure (CHF) in the terminal stage still receive inappropriate life-sustaining treatment before death. There is limited understanding of the status of intensive care unit (ICU) admission, mechanical ventilation (MV), cardiopulmonary resuscitation (CPR), and even extracorporeal membrane oxygenation (ECMO) for patients with CHF before death, as well as their use of hospice-related services. This study investigated the trends and trend changes in intensive procedures and hospice-related services for patients with CHF in the last month of life. This population-based retrospective observational study included 25 375 patients with CHF from the National Health Insurance research database in Taiwan and collected information on their intensive treatments during the last month of life. We computed intensive treatment utilization rates and analyzed the trends and trend changes via joinpoint regression. The average percentage of patients with CHF admitted to ICUs was 53.27% (n = 13 516). A total of 327 (1.29%) patients with CHF received ECMO. The percentages of patients receiving MV (54.3%’41.5%) and CPR (41.5%’17%) decreased over time. Conversely, the percentage of ECMO use (0.52%’1.78%) increased. However, only 222 (0.87%) patients with CHF received hospice care in the last month of life between 2001 and 2013. The rates of ICU admission and life-sustaining treatment among patients with CHF in the month before death remain high, and hospice-related services remain inadequate. This study highlights the need for research and training in providing palliative and hospice care for patients with CHF.


Persistent Identifierhttp://hdl.handle.net/10722/346477
ISSN
2023 Impact Factor: 1.7
2023 SCImago Journal Rankings: 0.580

 

DC FieldValueLanguage
dc.contributor.authorChou, Pi Ling-
dc.contributor.authorLin, Pei Chao-
dc.contributor.authorLin, Chia Chin-
dc.contributor.authorLee, Hsiang Chun-
dc.contributor.authorHuang, Yu Tung-
dc.date.accessioned2024-09-17T00:30:51Z-
dc.date.available2024-09-17T00:30:51Z-
dc.date.issued2024-03-20-
dc.identifier.citationINQUIRY: The Journal of Health Care Organization, Provision, and Financing, 2024, v. 61-
dc.identifier.issn0046-9580-
dc.identifier.urihttp://hdl.handle.net/10722/346477-
dc.description.abstract<p>A good death is a human right. Unfortunately, patients with chronic heart failure (CHF) in the terminal stage still receive inappropriate life-sustaining treatment before death. There is limited understanding of the status of intensive care unit (ICU) admission, mechanical ventilation (MV), cardiopulmonary resuscitation (CPR), and even extracorporeal membrane oxygenation (ECMO) for patients with CHF before death, as well as their use of hospice-related services. This study investigated the trends and trend changes in intensive procedures and hospice-related services for patients with CHF in the last month of life. This population-based retrospective observational study included 25 375 patients with CHF from the National Health Insurance research database in Taiwan and collected information on their intensive treatments during the last month of life. We computed intensive treatment utilization rates and analyzed the trends and trend changes via joinpoint regression. The average percentage of patients with CHF admitted to ICUs was 53.27% (n = 13 516). A total of 327 (1.29%) patients with CHF received ECMO. The percentages of patients receiving MV (54.3%’41.5%) and CPR (41.5%’17%) decreased over time. Conversely, the percentage of ECMO use (0.52%’1.78%) increased. However, only 222 (0.87%) patients with CHF received hospice care in the last month of life between 2001 and 2013. The rates of ICU admission and life-sustaining treatment among patients with CHF in the month before death remain high, and hospice-related services remain inadequate. This study highlights the need for research and training in providing palliative and hospice care for patients with CHF.</p>-
dc.languageeng-
dc.publisherSAGE Publications-
dc.relation.ispartofINQUIRY: The Journal of Health Care Organization, Provision, and Financing-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectheart failure-
dc.subjecthospice care-
dc.subjectintensive care-
dc.subjectpalliative care-
dc.subjectterminal care-
dc.titleTrends and Changes in Intensive Care Use for Patients With Heart Failure in the Last Month of Life-
dc.typeArticle-
dc.identifier.doi10.1177/00469580241239143-
dc.identifier.pmid38506439-
dc.identifier.scopuseid_2-s2.0-85188291674-
dc.identifier.volume61-
dc.identifier.eissn1945-7243-
dc.identifier.issnl0046-9580-

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