Effectiveness of Palliative Care before Death in Reducing Emergency Care Utilization for Patients with Terminal Cancer and Trends in the Utilization of Palliative Care from 2005–2018

Author:

Tsai Yi-Shiun12,Tsai Wen-Chen2ORCID,Chiu Li-Ting2,Kung Pei-Tseng34ORCID

Affiliation:

1. Department of Orthopedics, Feng Yuan Hospital, Feng Yuan, Taichung 420210, Taiwan

2. Department of Health Services Administration, College of Public Health, China Medical University, Taichung 406040, Taiwan

3. Department of Healthcare Administration, Asia University, Taichung 413305, Taiwan

4. Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan

Abstract

This retrospective cohort study aimed to examine the effect of palliative care for patients with terminal cancer on healthcare utilization. The National Health Insurance (NHI) Research Database and death certificates were utilized to identify patients who died of cancer between 2005 and 2018. The number of terminal cancer patients between 2005 and 2018 was 605,126. Propensity score matching and conditional logistic regression were performed. The odds ratios (ORs) for “emergency care utilization”, “CPR”, “endotracheal intubation”, and “ICU admission” were significantly lower for enrolled patients regardless of enrollment time compared to unenrolled patients. Compared to unenrolled patients, the OR for “emergency care utilization” increased from 0.34 to 0.68, the OR for “CPR use” increased from 0.13 to 0.26, the OR for “intubation” increased from 0.15 to 0.26, and the OR for “ICU admission” increased from 0.27 to 0.40 in enrolled patients. Between 2005 and 2010, CPR utilization, intubation, and ICU admission in patients enrolled in palliative care declined each year. Since the inclusion of palliative care in NHI (from 2010 onward), its utilization has increased slightly each year. Patients with terminal cancer enrolled in palliative care consume fewer medical resources before death than unenrolled patients; however, the difference decreases with longer times before death.

Funder

the Ministry of Science and Technology

Asia University, and China Medical University Hospital

Publisher

MDPI AG

Subject

Health Information Management,Health Informatics,Health Policy,Leadership and Management

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