Burden of Healthcare Utilization among Chronic Obstructive Pulmonary Disease Patients with and without Cancer Receiving Palliative Care: A Population-Based Study in Taiwan

Cheng, Kuo‐Chen; Chen, Chin‐Ming; Ko, Shian-Chin; Chen, Ping-Jen; Liao, Kuang-Ming; Ho, Chung‐Han

doi:10.3390/ijerph17144980

Cited by 6 publications

(8 citation statements)

References 43 publications

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“…34 A large Taiwanese study of PC involvement in patients with hepatic malignancy demonstrated a reduction in intenseive care unit and acute hospital admissions for patients supported by PC. 35 Our finding that the HepatoCare cohort experienced a reduction in hospital bed days is consistent with this and a recent US study found a substantial reduction in overall costs per patient with the integration of PC in this population. 36 Although assessing cost-effectiveness was not an objective of our study, these findings are certainly reassuring for health care providers.…”

Section: Discussionsupporting

confidence: 92%

“…ICU admission) in patients with advanced cirrhosis should make such patients ideal candidates for an integrated approach to supportive patient care 34 . A large Taiwanese study of PC involvement in patients with hepatic malignancy demonstrated a reduction in intenseive care unit and acute hospital admissions for patients supported by PC 35 . Our finding that the HepatoCare cohort experienced a reduction in hospital bed days is consistent with this and a recent US study found a substantial reduction in overall costs per patient with the integration of PC in this population 36 .…”

Section: Discussionmentioning

confidence: 99%

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Improving palliative and supportive care in advanced cirrhosis: the HepatoCare model of integrated collaborative care

Kearney,

Tiwari,

Cullen

et al. 2023

Internal Medicine Journal

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BackgroundPatients with advanced cirrhosis experience an unpredictable disease trajectory but are infrequently referred to palliative care (PC) services and rarely undertake advance care planning (ACP).AimWe assessed whether a novel model of care increased provision of meaningful PC in advanced cirrhosis compared with standard of care (SOC).MethodsThirty consecutive hepatology clinic outpatients with advanced cirrhosis, meeting one or more cirrhosis‐related PC referral criteria, consented to treatment in the HepatoCare clinic (PC physician, specialist liver nurse, pharmacist) in parallel with usual specialist hepatology care. A control cohort of 30 consecutive outpatients with advanced cirrhosis undergoing SOC treatment was retrospectively identified for comparison. The primary outcome was provision of meaningful PC using HepatoCare versus SOC. Additional clinical outcomes were assessed over 12 months or until death and significant differences were identified.ResultsThe intervention and control cohorts had similarly advanced cirrhosis (mean Child‐Pugh scores 8.7 vs 8.2, P = 0.46; mean model for end‐stage liver disease scores 14.4 vs 14.6, P = 0.88) but a lower 12‐month mortality rate (33% HepatoCare vs 67% SOC; P = 0.02). The intervention cohort experienced higher uptake of formal ACP (100% vs 25% for the control cohort) and outpatient PC referral (100% vs 40%), and were more likely to die at home or in a PC bed/hospice (80% vs 30%). The majority of the HepatoCare cohort (81%) had medications safely deprescribed and experienced fewer unplanned admission days (470 vs 794).ConclusionsHepatoCare is a novel multidisciplinary model of care that integrates effective PC and specialist hepatology management to improve outcomes in advanced cirrhosis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Improving palliative and supportive care in advanced cirrhosis: the HepatoCare model of integrated collaborative care

Kearney,

Tiwari,

Cullen

et al. 2023

Internal Medicine Journal

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“…Chronic diseases have become an economic burden on health care worldwide [ 30 , 31 , 32 ]; patients present with mental and physical distress in their evolution [ 33 ] with chronic diseases such as cancer requiring long-term observation for decreased function and a greater episode of unpredictable acute care [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Study on the Socio-Economic Impact of Cancer Disease on Cancer Patients and Their Relatives

et al. 2022

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Background: Cancer is one of the most relevant social and health problems in the world. The disease entails additional costs for cancer patients and their families that are not covered by the public part of our welfare state, and which they assume themselves simply because they are ill. The main objective of this study is to identify and analyse the additional cost and socioeconomic impact of cancer disease on patients diagnosed with cancer disease and their families. Methods: Descriptive cross-sectional randomised observational epidemiological study without replacement with prevalence of cancer disease in the study base, carried out in the Medical Oncology Service of the Complejo Asistencial Universitario de Salamanca (CAUSA), Spain. Results: The study variable has been the additional cost of the cancer disease for cancer patients and their families that is not covered by our autonomous health system. Conclusions: Cancer disease entails an additional cost for the patient and family; more specifically, for 55% of the patients in the study sample, the diagnosis of cancer represents extra expenditure of between 8.38–9.67% of their annual income. Furthermore, the disability and dependence of patients does not represent an additional cost due to their levels of functionality, but it can have repercussions on the future cost of the evolution of the disease, in addition to the fact of having cancer.

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“…Many family caregivers in Taiwan believe that artificial nutrition is essential to basic care; thus, they are reluctant to withdraw aggressive artificial nutrition even in the terminal stage. 25,[31][32][33] The gaps and disparities of resource utilization and life-sustaining support between palliative care and acute intensive care should be explored further in patients with glioblastoma.…”

Section: Physical Restraints and Artificial Nutritionmentioning

confidence: 99%

Comparison of healthcare utilization and life-sustaining interventions between patients with glioblastoma receiving palliative care or not: A population-based study

Shieh

Guo

et al. 2023

Palliat Med

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Background: Palliative care has historically been under-utilized in patients with glioblastoma. Furthermore, literature on the utilization of healthcare and life-sustaining interventions during the late-stage of glioblastoma has been limited. Aim: To identify and compare healthcare utilization and life-sustaining interventions between patients with glioblastoma who received palliative care and who did not based on patients identified retrospectively from Taiwan Cancer Registry between January 2007 and December 2017. Design: In this study, palliative care was defined on the basis of claims submitted to the National Health Insurance, which has a specific code for it. Variables included demographic characteristics, the utilization of healthcare services, and invasive life-sustaining interventions. Setting/participants: Of the 1994 patients with glioblastoma identified, 1784 fulfilled the inclusion criteria, 613 (34%) of whom received palliative care. Results: The survival of patients with glioblastoma under palliative care was significantly longer than that of those without palliative care. Those without palliative care had significantly more frequent intensive care unit admissions and a longer cumulative length of intensive care unit stay. Regarding cardiopulmonary or respiratory treatments, patients without palliative care had significantly more invasive interventions than those with palliative care. Patients receiving palliative care had significantly lower odds than those without life-sustaining interventions. Conclusions: Our retrospective analysis reveals that glioblastoma patients without palliative care had greater odds of receiving life-sustaining treatments within 1 year before their death, although no gains in survival as compared to those that received palliative care. These findings highlight the urgent need for palliative care in caring for patients with glioblastoma.

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Burden of Healthcare Utilization among Chronic Obstructive Pulmonary Disease Patients with and without Cancer Receiving Palliative Care: A Population-Based Study in Taiwan

Cited by 6 publications

References 43 publications

Improving palliative and supportive care in advanced cirrhosis: the HepatoCare model of integrated collaborative care

Improving palliative and supportive care in advanced cirrhosis: the HepatoCare model of integrated collaborative care

Study on the Socio-Economic Impact of Cancer Disease on Cancer Patients and Their Relatives

Comparison of healthcare utilization and life-sustaining interventions between patients with glioblastoma receiving palliative care or not: A population-based study

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