Determinants of aggressive end-of-life care for Taiwanese cancer decedents, 2001 to 2006

Siew Tzuh Tang, Shiao Chi Wu, Yen Ni Hung, Jen Shi Chen, Ean Wen Huang, Tsang Wu Liu

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Purpose: To assess the association between aggressiveness of end-of-life (EOL) care and patient demographics, disease characteristics, primary physician's specialty, hospital characteristics, and availability of health care resources at the hospital and regional levels in Taiwan for a cohort of 210,976 cancer decedents in 2001 to 2006. Methods: This retrospective cohort study examined administrative data. Aggressiveness of EOL care was examined by a composite measure adapted from Earle et al. Scores range from 0 to 6, with higher scores indicating more aggressive EOL care. Results: The mean composite score for aggressiveness of EOL care was 2.04 (mean) ± 1.26 (standard deviation), increasing from 1.96 ± 1.26 in 2001 to 2.10 ± 1.26 in 2006. Each successive year of death significantly increased the composite score. Cancer decedents received more aggressive EOL care if they were male, younger, single, had a higher level of comorbidity, had more malignant and extensive diseases or hematologic malignancies, were cared for by oncologists, and received care in a hospital with a greater density of beds. Conclusion: Controlling for patient demographics and cormorbidity burden, EOL care in Taiwan was more aggressive for patients with cancer with highly malignant and extensive diseases, for patients with oncologists as primary care providers, or in hospitals with abundant health care resources. Health policies should aim to ensure that all patients receive treatments that best meet their individual needs and interests and that resources are devoted to care that produces the greatest health benefits.

Original languageEnglish
Pages (from-to)4613-4618
Number of pages6
JournalJournal of Clinical Oncology
Volume27
Issue number27
DOIs
Publication statusPublished - Sep 20 2009
Externally publishedYes

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Terminal Care
Neoplasms
Health Resources
Taiwan
Demography
Delivery of Health Care
Insurance Benefits
Hematologic Neoplasms
Health Policy
Comorbidity
Primary Health Care
Cohort Studies
Retrospective Studies
Physicians

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Tang, S. T., Wu, S. C., Hung, Y. N., Chen, J. S., Huang, E. W., & Liu, T. W. (2009). Determinants of aggressive end-of-life care for Taiwanese cancer decedents, 2001 to 2006. Journal of Clinical Oncology, 27(27), 4613-4618. https://doi.org/10.1200/JCO.2008.20.5096

Determinants of aggressive end-of-life care for Taiwanese cancer decedents, 2001 to 2006. / Tang, Siew Tzuh; Wu, Shiao Chi; Hung, Yen Ni; Chen, Jen Shi; Huang, Ean Wen; Liu, Tsang Wu.

In: Journal of Clinical Oncology, Vol. 27, No. 27, 20.09.2009, p. 4613-4618.

Research output: Contribution to journalArticle

Tang, Siew Tzuh ; Wu, Shiao Chi ; Hung, Yen Ni ; Chen, Jen Shi ; Huang, Ean Wen ; Liu, Tsang Wu. / Determinants of aggressive end-of-life care for Taiwanese cancer decedents, 2001 to 2006. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 27. pp. 4613-4618.
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