End-of-Life Health Care Utilization Between Chronic Obstructive Pulmonary Disease and Lung Cancer Patients

Lou Ching Kuo, Jin Hua Chen, Chih Hsin Lee, Ching Wen Tsai, Chia-Chin Lin

研究成果: 雜誌貢獻文章

1 引文 (Scopus)

摘要

Context: At the end of life, chronic obstructive pulmonary disease (COPD) and lung cancer (LC) patients exhibit similar symptoms; however, a large-scale study comparing end-of-life health care utilization between these two groups has not been conducted in East Asia. Objectives: To explore and compare end-of-life resource use during the last six months before death between COPD and LC patients. Methods: Using data from the Taiwan National Health Insurance Research Database, we conducted a nationwide retrospective cohort study in COPD (n = 8640) and LC (n = 3377) patients who died between 1997 and 2013. Results: The COPD decedents were more likely to be admitted to intensive care units (57.59% vs 29.82%), to have longer intensive care unit stays (17.59 vs 9.93 days), and to undergo intensive procedures than the LC decedents during their last six months; they were less likely to receive inpatient (3.32% vs 18.24%) or home-based palliative care (0.84% vs 8.17%) and supportive procedures than the LC decedents during their last six months. The average total medical cost during the last six months was approximately 18.42% higher for the COPD decedents than for the LC decedents. Conclusion: Higher intensive health care resource use, including intensive procedure use, at the end of life suggests a focus on prolonging life in COPD patients; it also indicates an unmet demand for palliative care in these patients. Avoiding potentially inappropriate care and improving end-of-life care quality by providing palliative care to COPD patients are necessary.

原文英語
頁(從 - 到)933-943
頁數11
期刊Journal of Pain and Symptom Management
57
發行號5
DOIs
出版狀態已發佈 - 五月 1 2019

指紋

Patient Acceptance of Health Care
Terminal Care
Chronic Obstructive Pulmonary Disease
Lung Neoplasms
Palliative Care
Intensive Care Units
Far East
Health Resources
National Health Programs
Critical Care
Taiwan
Inpatients
Cohort Studies
Retrospective Studies
Quality of Life
Databases
Delivery of Health Care
Costs and Cost Analysis

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

引用此文

End-of-Life Health Care Utilization Between Chronic Obstructive Pulmonary Disease and Lung Cancer Patients. / Kuo, Lou Ching; Chen, Jin Hua; Lee, Chih Hsin; Tsai, Ching Wen; Lin, Chia-Chin.

於: Journal of Pain and Symptom Management, 卷 57, 編號 5, 01.05.2019, p. 933-943.

研究成果: 雜誌貢獻文章

@article{8c352d2a4fd54684b268a985276ab2c8,
title = "End-of-Life Health Care Utilization Between Chronic Obstructive Pulmonary Disease and Lung Cancer Patients",
abstract = "Context: At the end of life, chronic obstructive pulmonary disease (COPD) and lung cancer (LC) patients exhibit similar symptoms; however, a large-scale study comparing end-of-life health care utilization between these two groups has not been conducted in East Asia. Objectives: To explore and compare end-of-life resource use during the last six months before death between COPD and LC patients. Methods: Using data from the Taiwan National Health Insurance Research Database, we conducted a nationwide retrospective cohort study in COPD (n = 8640) and LC (n = 3377) patients who died between 1997 and 2013. Results: The COPD decedents were more likely to be admitted to intensive care units (57.59{\%} vs 29.82{\%}), to have longer intensive care unit stays (17.59 vs 9.93 days), and to undergo intensive procedures than the LC decedents during their last six months; they were less likely to receive inpatient (3.32{\%} vs 18.24{\%}) or home-based palliative care (0.84{\%} vs 8.17{\%}) and supportive procedures than the LC decedents during their last six months. The average total medical cost during the last six months was approximately 18.42{\%} higher for the COPD decedents than for the LC decedents. Conclusion: Higher intensive health care resource use, including intensive procedure use, at the end of life suggests a focus on prolonging life in COPD patients; it also indicates an unmet demand for palliative care in these patients. Avoiding potentially inappropriate care and improving end-of-life care quality by providing palliative care to COPD patients are necessary.",
keywords = "COPD, End-of-life care, lung cancer",
author = "Kuo, {Lou Ching} and Chen, {Jin Hua} and Lee, {Chih Hsin} and Tsai, {Ching Wen} and Chia-Chin Lin",
year = "2019",
month = "5",
day = "1",
doi = "10.1016/j.jpainsymman.2019.01.011",
language = "English",
volume = "57",
pages = "933--943",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - End-of-Life Health Care Utilization Between Chronic Obstructive Pulmonary Disease and Lung Cancer Patients

AU - Kuo, Lou Ching

AU - Chen, Jin Hua

AU - Lee, Chih Hsin

AU - Tsai, Ching Wen

AU - Lin, Chia-Chin

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Context: At the end of life, chronic obstructive pulmonary disease (COPD) and lung cancer (LC) patients exhibit similar symptoms; however, a large-scale study comparing end-of-life health care utilization between these two groups has not been conducted in East Asia. Objectives: To explore and compare end-of-life resource use during the last six months before death between COPD and LC patients. Methods: Using data from the Taiwan National Health Insurance Research Database, we conducted a nationwide retrospective cohort study in COPD (n = 8640) and LC (n = 3377) patients who died between 1997 and 2013. Results: The COPD decedents were more likely to be admitted to intensive care units (57.59% vs 29.82%), to have longer intensive care unit stays (17.59 vs 9.93 days), and to undergo intensive procedures than the LC decedents during their last six months; they were less likely to receive inpatient (3.32% vs 18.24%) or home-based palliative care (0.84% vs 8.17%) and supportive procedures than the LC decedents during their last six months. The average total medical cost during the last six months was approximately 18.42% higher for the COPD decedents than for the LC decedents. Conclusion: Higher intensive health care resource use, including intensive procedure use, at the end of life suggests a focus on prolonging life in COPD patients; it also indicates an unmet demand for palliative care in these patients. Avoiding potentially inappropriate care and improving end-of-life care quality by providing palliative care to COPD patients are necessary.

AB - Context: At the end of life, chronic obstructive pulmonary disease (COPD) and lung cancer (LC) patients exhibit similar symptoms; however, a large-scale study comparing end-of-life health care utilization between these two groups has not been conducted in East Asia. Objectives: To explore and compare end-of-life resource use during the last six months before death between COPD and LC patients. Methods: Using data from the Taiwan National Health Insurance Research Database, we conducted a nationwide retrospective cohort study in COPD (n = 8640) and LC (n = 3377) patients who died between 1997 and 2013. Results: The COPD decedents were more likely to be admitted to intensive care units (57.59% vs 29.82%), to have longer intensive care unit stays (17.59 vs 9.93 days), and to undergo intensive procedures than the LC decedents during their last six months; they were less likely to receive inpatient (3.32% vs 18.24%) or home-based palliative care (0.84% vs 8.17%) and supportive procedures than the LC decedents during their last six months. The average total medical cost during the last six months was approximately 18.42% higher for the COPD decedents than for the LC decedents. Conclusion: Higher intensive health care resource use, including intensive procedure use, at the end of life suggests a focus on prolonging life in COPD patients; it also indicates an unmet demand for palliative care in these patients. Avoiding potentially inappropriate care and improving end-of-life care quality by providing palliative care to COPD patients are necessary.

KW - COPD

KW - End-of-life care

KW - lung cancer

UR - http://www.scopus.com/inward/record.url?scp=85062811059&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85062811059&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2019.01.011

DO - 10.1016/j.jpainsymman.2019.01.011

M3 - Article

VL - 57

SP - 933

EP - 943

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

IS - 5

ER -