Emergency Department Attendance by Patients With Cancer in Their Last Month of Life: A Systematic Review and Meta-Analysis

Henson, Lesley A.; Gao, Wei; Higginson, Irene J; Smith, M. J. H.; Davies, Joanna M.; Ellis‐Smith, Clare; Daveson, Barbara A

doi:10.1200/jco.2014.57.3568

Cited by 107 publications

(117 citation statements)

References 68 publications

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“…For example, lack of access for rural residents to community-based services after clinical hours likely increases reliance on hospital care. That finding is supported by numerous studies [13][14][15] . Further work is needed to better understand the landscape of end-of-life care in Canada:…”

Section: Discussionsupporting

confidence: 77%

Acute Care Hospitalization Near the End of Life for Cancer Patients Who Die in Hospital in Canada

et al. 2017

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Acute care hospitals have a role in managing the health care needs of people affected by cancer when they are at the end of life. However, there is a need to provide end-of-life care in other settings, including at home or in hospice, when such settings are more appropriate. Using data from 9 provinces, we examined indicators that describe the current landscape of acute care hospital use at the end of life for patients who died of cancer in hospital in Canada.Interprovincial variation was observed in acute care hospital deaths, length of stay in hospital, readmission to hospital, and intensive care unit use at the end of life. High rates of acute care hospital use near the end of life might suggest that community and home-based end-of-life care might not be suiting patient needs.

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Section: Discussionsupporting

confidence: 77%

Acute Care Hospitalization Near the End of Life for Cancer Patients Who Die in Hospital in Canada

et al. 2017

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“…39 Palliative care consultations for patients with advanced cancer have also been shown to reduce the quantity and intensity of life-prolonging care received toward the EOL. [40][41][42][43][44] Conversely, the lack of palliative care team consultation has been shown to be a predisposing factor for futile life-sustaining treatments at EOL. 45 An observational study suggested that inpatient palliative care led to fewer or no transitions in care settings at EOL.…”

Section: Eol Care In Oncologymentioning

confidence: 99%

“…These services have been associated with a reduced need for EOL emergency department visits, reduced length and frequency of hospitalization, and fewer intensive care unit (ICU) admissions and in-hospital deaths. [40][41][42][43][44] Palliative care has been shown to reduce symptom burden, improve QOL, and increase the odds of dying at home. Similarly, a 2013 Cochrane Database systematic review that analyzed home palliative care in patients with advanced illness demonstrated a reliable reduction of symptom burden and an increased likelihood of dying at home without a negative impact on caregiver grief.…”

Section: Eol Care In Oncologymentioning

confidence: 99%

NCCN Guidelines Insights: Palliative Care, Version 2.2017

Dans¹,

Smith²,

Back³

et al. 2017

J Natl Compr Canc Netw

112

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“…Among factors influencing hospital deaths are underlying cause of death, for example hematological cancer, and the availability of acute hospitals and inpatient beds, whereas factors influencing home deaths include living with relatives, having a partner and socioeconomic status [3]. Other factors that seem to influence hospital deaths are emergency department attendance in the last month of life for people with low socioeconomic status, being male and dying of lung cancer [9]. Metropolitan populations have been shown to be less likely to die at home in some countries [10], and impact of socioeconomic deprivation varies by geographical region rather than urban or rural residence [11].…”

mentioning

confidence: 99%

Determinants in the place of death for people with different cancer types: a national population-based study

2016

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Background: Place of death has for the past decade increasingly come to be regarded as a robust indicator of how palliative care is organized and provided, and is also recognized as an important factor for well being at the end of life. Variations in place of cancer deaths have previously been reported in the context of country-specific healthcare organization, but without differentiating between cancer types and national regional variations. Our aim was to examine, at a population level, where people with cancer diseases die in Sweden, and to investigate associations of place of death and cancer type with individual, socioeconomic and geographical characteristics of the deceased. Material and methods: This population level study is based on death certificate data (sex; age; underlying cause of death and place of death) and population register data (educational attainment, marital status, living arrangements, area of residence, degree of urbanization, and healthcare region) of all 2012 cancer deaths in Sweden, with a registered place of death (hospital, nursing home, home, other places). Data were explored descriptively. To investigate associations between place of death and cancer types, and individual, socioeconomic and environmental characteristics, a series of multivariable logistic regression analyses were performed. Results: The most frequent type of cancer death occurring at home was upper gastrointestinal cancer (25.6%) and the least frequent was hematological cancer (15.2%). Regional variations in cancer deaths occurring at home ranged from 17.1% to 28.4%. Factors associated with place of death by cancer type were age, educational attainment, marital status, healthcare regions and degree of urbanization. Conclusion: Large healthcare regional variations in place of death among different cancer types were found. The socioeconomic inequality previously demonstrated for screening, diagnostic and treatment processes, rehabilitation and survival thus also seems to be reflected in the place of death.

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Emergency Department Attendance by Patients With Cancer in Their Last Month of Life: A Systematic Review and Meta-Analysis

Cited by 107 publications

References 68 publications

Acute Care Hospitalization Near the End of Life for Cancer Patients Who Die in Hospital in Canada

Acute Care Hospitalization Near the End of Life for Cancer Patients Who Die in Hospital in Canada

NCCN Guidelines Insights: Palliative Care, Version 2.2017

Determinants in the place of death for people with different cancer types: a national population-based study

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