Quality of end-of-life care between medical oncologists and other physician specialists for Taiwanese cancer decedents, 2001-2006

Tsang Wu Liu, Jen Shi Chen, Hung Ming Wang, Shiao Chi Wu, Yen Ni Hung, Siew Tzuh Tang

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background. Oncologists play a significant role in cancer care throughout the cancer trajectory and have traditionally emphasized underuse of procedures/treatments with well-established effectiveness as the source of poor care quality with little attention to overusing end-of-life (EOL) care. The purpose of this populationbased study was to compare the quality of EOL care between medical oncologists and other physician specialists. Methods. This retrospective cohort study compared indicators of poor quality EOL care by examining administrative data for 204,850 Taiwanese cancer decedents in 2001-2006. Results. Taiwanese cancer patients whose primary physician was a medical oncologist were significantly more likely than patients of other physician specialists to receive chemotherapy and to spend >14 days in a hospital in the last month of life. However, they were significantly less likely than patients of other physician specialists to visit the emergency room (ER) more than once and to use intensive care unit (ICU) care, cardiopulmonary resuscitation (CPR), intubation, and mechanical ventilation in the last month of life. Conclusion. The quality of EOL cancer care in Taiwan varied significantly by physician specialty. Cancer decedents cared for by medical oncologists were more likely to receive chemotherapy and prolonged hospitalization but less likely to have multiple ER visits, ICU care, or undergo CPR, intubation, or mechanical ventilation in the last month of life than patients of other physician specialists.

Original languageEnglish
Pages (from-to)1232-1241
Number of pages10
JournalOncologist
Volume14
Issue number12
DOIs
Publication statusPublished - 2009
Externally publishedYes

Fingerprint

Terminal Care
Quality of Life
Physicians
Neoplasms
Cardiopulmonary Resuscitation
Artificial Respiration
Intubation
Intensive Care Units
Hospital Emergency Service
Drug Therapy
Quality of Health Care
Taiwan
Oncologists
Hospitalization
Cohort Studies
Retrospective Studies

Keywords

  • End-of-life care
  • Medical oncologists
  • Physician specialty
  • Quality of care

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Quality of end-of-life care between medical oncologists and other physician specialists for Taiwanese cancer decedents, 2001-2006. / Liu, Tsang Wu; Chen, Jen Shi; Wang, Hung Ming; Wu, Shiao Chi; Hung, Yen Ni; Tang, Siew Tzuh.

In: Oncologist, Vol. 14, No. 12, 2009, p. 1232-1241.

Research output: Contribution to journalArticle

Liu, Tsang Wu ; Chen, Jen Shi ; Wang, Hung Ming ; Wu, Shiao Chi ; Hung, Yen Ni ; Tang, Siew Tzuh. / Quality of end-of-life care between medical oncologists and other physician specialists for Taiwanese cancer decedents, 2001-2006. In: Oncologist. 2009 ; Vol. 14, No. 12. pp. 1232-1241.
@article{f233d45997b84edfbe630a648a82135b,
title = "Quality of end-of-life care between medical oncologists and other physician specialists for Taiwanese cancer decedents, 2001-2006",
abstract = "Background. Oncologists play a significant role in cancer care throughout the cancer trajectory and have traditionally emphasized underuse of procedures/treatments with well-established effectiveness as the source of poor care quality with little attention to overusing end-of-life (EOL) care. The purpose of this populationbased study was to compare the quality of EOL care between medical oncologists and other physician specialists. Methods. This retrospective cohort study compared indicators of poor quality EOL care by examining administrative data for 204,850 Taiwanese cancer decedents in 2001-2006. Results. Taiwanese cancer patients whose primary physician was a medical oncologist were significantly more likely than patients of other physician specialists to receive chemotherapy and to spend >14 days in a hospital in the last month of life. However, they were significantly less likely than patients of other physician specialists to visit the emergency room (ER) more than once and to use intensive care unit (ICU) care, cardiopulmonary resuscitation (CPR), intubation, and mechanical ventilation in the last month of life. Conclusion. The quality of EOL cancer care in Taiwan varied significantly by physician specialty. Cancer decedents cared for by medical oncologists were more likely to receive chemotherapy and prolonged hospitalization but less likely to have multiple ER visits, ICU care, or undergo CPR, intubation, or mechanical ventilation in the last month of life than patients of other physician specialists.",
keywords = "End-of-life care, Medical oncologists, Physician specialty, Quality of care",
author = "Liu, {Tsang Wu} and Chen, {Jen Shi} and Wang, {Hung Ming} and Wu, {Shiao Chi} and Hung, {Yen Ni} and Tang, {Siew Tzuh}",
year = "2009",
doi = "10.1634/theoncologist.2009-0095",
language = "English",
volume = "14",
pages = "1232--1241",
journal = "Oncologist",
issn = "1083-7159",
publisher = "AlphaMed Press",
number = "12",

}

TY - JOUR

T1 - Quality of end-of-life care between medical oncologists and other physician specialists for Taiwanese cancer decedents, 2001-2006

AU - Liu, Tsang Wu

AU - Chen, Jen Shi

AU - Wang, Hung Ming

AU - Wu, Shiao Chi

AU - Hung, Yen Ni

AU - Tang, Siew Tzuh

PY - 2009

Y1 - 2009

N2 - Background. Oncologists play a significant role in cancer care throughout the cancer trajectory and have traditionally emphasized underuse of procedures/treatments with well-established effectiveness as the source of poor care quality with little attention to overusing end-of-life (EOL) care. The purpose of this populationbased study was to compare the quality of EOL care between medical oncologists and other physician specialists. Methods. This retrospective cohort study compared indicators of poor quality EOL care by examining administrative data for 204,850 Taiwanese cancer decedents in 2001-2006. Results. Taiwanese cancer patients whose primary physician was a medical oncologist were significantly more likely than patients of other physician specialists to receive chemotherapy and to spend >14 days in a hospital in the last month of life. However, they were significantly less likely than patients of other physician specialists to visit the emergency room (ER) more than once and to use intensive care unit (ICU) care, cardiopulmonary resuscitation (CPR), intubation, and mechanical ventilation in the last month of life. Conclusion. The quality of EOL cancer care in Taiwan varied significantly by physician specialty. Cancer decedents cared for by medical oncologists were more likely to receive chemotherapy and prolonged hospitalization but less likely to have multiple ER visits, ICU care, or undergo CPR, intubation, or mechanical ventilation in the last month of life than patients of other physician specialists.

AB - Background. Oncologists play a significant role in cancer care throughout the cancer trajectory and have traditionally emphasized underuse of procedures/treatments with well-established effectiveness as the source of poor care quality with little attention to overusing end-of-life (EOL) care. The purpose of this populationbased study was to compare the quality of EOL care between medical oncologists and other physician specialists. Methods. This retrospective cohort study compared indicators of poor quality EOL care by examining administrative data for 204,850 Taiwanese cancer decedents in 2001-2006. Results. Taiwanese cancer patients whose primary physician was a medical oncologist were significantly more likely than patients of other physician specialists to receive chemotherapy and to spend >14 days in a hospital in the last month of life. However, they were significantly less likely than patients of other physician specialists to visit the emergency room (ER) more than once and to use intensive care unit (ICU) care, cardiopulmonary resuscitation (CPR), intubation, and mechanical ventilation in the last month of life. Conclusion. The quality of EOL cancer care in Taiwan varied significantly by physician specialty. Cancer decedents cared for by medical oncologists were more likely to receive chemotherapy and prolonged hospitalization but less likely to have multiple ER visits, ICU care, or undergo CPR, intubation, or mechanical ventilation in the last month of life than patients of other physician specialists.

KW - End-of-life care

KW - Medical oncologists

KW - Physician specialty

KW - Quality of care

UR - http://www.scopus.com/inward/record.url?scp=75449108024&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=75449108024&partnerID=8YFLogxK

U2 - 10.1634/theoncologist.2009-0095

DO - 10.1634/theoncologist.2009-0095

M3 - Article

C2 - 20007642

AN - SCOPUS:75449108024

VL - 14

SP - 1232

EP - 1241

JO - Oncologist

JF - Oncologist

SN - 1083-7159

IS - 12

ER -