Comparison of healthcare utilization and life-sustaining interventions between elderly patients with dementia and those with cancer near the end of life: A nationwide, population-based study in Taiwan

doi:10.1111/ggi.13084

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Title:	Comparison of healthcare utilization and life-sustaining interventions between elderly patients with dementia and those with cancer near the end of life: A nationwide, population-based study in Taiwan
Authors:	Chen, Yu-Han Ho, Chung-Han Huang, Chien-Cheng Hsu, Ya-Wen Chen, Yueh-Chun Chen, Ping-Jen Chen, Guan-Ting Wang, Jhi-Joung
Contributors:	Chi Mei Med Ctr, Palliat Care Ctr Chi Mei Med Ctr, Dept Family Med Chi Mei Med Ctr, Dept Med Res Chi Mei Med Ctr, Dept Emergency Med Chi Mei Med Ctr, Dept Geriatr & Gerontol Chi Mei Med Ctr, Dept Nursing Chi Mei Med Ctr, Dept Anesthesiol Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Natl Cheng Kung Univ, Dept Environm & Occupat Hlth, Coll Med Southern Taiwan Univ Sci & Technol, Bachlor Program Senior Serv
Keywords:	cancer dementia end-of-life life-sustaining treatment utilization
Date:	2017-12
Issue Date:	2018-11-30 15:51:42 (UTC+8)
Publisher:	Wiley
Abstract:	AimLittle is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. MethodsTaiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared. ResultsOf the 2724 patients enrolled, 908 had dementia and 1816 had cancer. PwD were more likely to have a higher frequency of admission to hospital and intensive care unit, and longer stays compared with cancer patients. PwD had a higher risk of enteral tube insertion and feeding, endotracheal intubation and tracheostomy, mechanical ventilation, hemodialysis and cardiopulmonary resuscitation (OR 4.36, 95% CI 3.51-5.41), which was the highest among the selected procedures. ConclusionsPwD in their last year of life in Taiwan underwent aggressive interventions significantly more frequently than did their counterparts in Western countries. Providing comfort-centered care for better quality of life for end-of-life PwD is a priority of Taiwan's national health policy. Geriatr Gerontol Int 2017; 17: 2545-2551.
Relation:	Geriatrics & Gerontology International, v.17, n.12, pp.2545-2551
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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