Place of Death and Its Predictors for Local Patients Registered at a Comprehensive Cancer Center

Bruera, Éduardo; Russell, Nancy; Sweeney, C. Renn Upchurch; Fisch, Michael J.; Palmer, J. Lynn

doi:10.1200/jco.2002.08.138

Cited by 128 publications

(107 citation statements)

References 23 publications

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“…Results in the literature regarding the association with age or gender and end-of-life services are conflicting (Burge et al 2003(Burge et al , 2008Earle et al 2004;grande et al 1998;Bruera et al 2002;gomes and Higginson 2006). Our finding that low neighbourhood income quintile is associated with fewer patients receiving house calls or home care is consistent with similar studies in cancer (grande et al 1998;Burge et al 2005;Huang et al 2002).…”

Section: Other Findings From the Literaturesupporting

confidence: 83%

Factors Associated with End-of-Life Health Service Use in Patients Dying of Cancer

Barbera¹,

Sussman²,

Viola³

et al. 2010

hcpol

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This study describes acute care hospital death, physician house calls and home care near the end of life among patients who died of cancer and the factors that are associated with these events and services. It is a population-based retrospective study that uses linked administrative healthcare data. The cohort includes all patients who died of cancer between 2000 and 2004 in Ontario, Canada.Fifty-five per cent of patients died in acute care hospital, 68% received home care in the last 6 months of life and 24% received at least one physician house call in the last 2 weeks of life. Increased age was associated with a decreased likelihood of each event or service. women were less likely to die in acute care and more likely to receive home care. Residents in low-income neighbourhoods were less likely to receive house calls or home care. Patients who received home care or house calls were less likely to die in acute care.Our observations add to those in the literature, suggesting a need to increase the use of supportive care services at the end of life in hopes of decreasing the need for acute care. They also serve as a baseline for future comparison, which is of particular interest since new government policies directed at end-of-life care were recently introduced.

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Section: Other Findings From the Literaturesupporting

confidence: 83%

Factors Associated with End-of-Life Health Service Use in Patients Dying of Cancer

Barbera¹,

Sussman²,

Viola³

et al. 2010

hcpol

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show abstract

“…The absence of a clear emphasis related to location of death was surprising given that surveys consistently indicate that most people prefer to die at home. 15,16 In contrast, clergy expressed that a good death could happen in a variety of locations-home, an inpatient hospice facility, or the ICUand verbalized much greater concern for the spiritual status of the dying patient, and the people surrounding them, than for the physical location of the death event. Clergy did not appear to strongly link some of the key factors they felt influenced the death experience (dignity, community, physical suffering, preparedness) to a physical location's ability to support these factors.…”

Section: Discussionmentioning

confidence: 99%

Clergy Views on a Good Versus a Poor Death: Ministry to the Terminally Ill

LeBaron

Cooke

Resmini

et al. 2015

Journal of Palliative Medicine

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Background: Clergy are often important sources of guidance for patients and family members making medical decisions at the end-of-life (EOL). Previous research revealed spiritual support by religious communities led to more aggressive care at the EOL, particularly among minority patients. Understanding this phenomenon is important to help address disparities in EOL care. Objective: The study objective was to explore and describe clergy perspectives regarding ''good'' versus ''poor'' death within the participant's spiritual tradition. Methods: This was a qualitative, descriptive study. Community clergy from various spiritual backgrounds, geographical locations within the United States, and races/ethnicities were recruited. Participants included 35 clergy who participated in one-on-one interviews (N = 14) and two focus groups (N = 21). Semistructured interviews explored clergy viewpoints on factors related to a ''good death.'' Principles of grounded theory were used to identify a final set of themes and subthemes. Results: A good death was characterized by wholeness and certainty and emphasized being in relationship with God. Conversely, a ''poor death'' was characterized by separation, doubt, and isolation. Clergy identified four primary determinants of good versus poor death: dignity, preparedness, physical suffering, and community. Participants expressed appreciation for contextual factors that affect the death experience; some described a ''middle death,'' or one that integrates both positive and negative elements. Location of death was not viewed as a significant contributing factor. Conclusions: Understanding clergy perspectives regarding quality of death can provide important insights to help improve EOL care, particularly for patients highly engaged with faith communities. These findings can inform initiatives to foster productive relationships between clergy, clinicians, and congregants and reduce health disparities.

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“…Patients with hematologic malignancies have significant palliative care needs, including high symptom burden [15][16][17] ; however, they remain less likely than patients with solid tumors to receive specialist palliative care services and more likely to receive aggressive health care at the end of life. 18 Specifically, patients with blood cancers are less frequent users of hospice services, 19 less likely to be seen by consultative palliative care services in the hospital, 20 more likely to die in a hospital or intensive care unit, [21][22][23] and more likely to receive chemotherapy in the last few weeks of life. 24 These findings point toward unmet palliative care needs in the hematologic malignancy population.…”

mentioning

confidence: 99%

Perceptions of palliative care among hematologic malignancy specialists: A mixed-methods study.

LeBlanc

O’Donnell

Crowley-Makota

et al. 2014

JCO

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Purpose: Patients with hematologic malignancies are less likely to receive specialist palliative care services than patients with solid tumors. Reasons for this difference are poorly understood. Methods:This was a multisite, mixed-methods study to understand and contrast perceptions of palliative care among hematologic and solid tumor oncologists using surveys assessing referral practices and in-depth semistructured interviews exploring views of palliative care. We compared referral patterns using standard statistical methods. We analyzed qualitative interview data using constant comparative methods to explore reasons for observed differences.Results: Among 66 interviewees, 23 oncologists cared exclusively for patients with hematologic malignancies; 43 treated only patients with solid tumors. Seven (30%) of 23 hematologic oncologists reported never referring to palliative care; all solid tumor oncologists had previously referred. In qualitative analyses, most hematologic oncologists viewed palliative care as end-of-life care, whereas most solid tumor oncologists viewed palliative care as a subspecialty that could assist with complex patient cases. Solid tumor oncologists emphasized practical barriers to palliative care referral, such as appointment availability and reimbursement issues. Hematologic oncologists emphasized philosophic concerns about palliative care referrals, including different treatment goals, responsiveness to chemotherapy, and preference for controlling even palliative aspects of patient care. Conclusion: Most hematologic oncologists view palliative careas end-of-life care, whereas solid tumor oncologists more often view palliative care as a subspecialty for comanaging patients with complex cases. Efforts to integrate palliative care into hematologic malignancy practices will require solutions that address unique barriers to palliative care referral experienced by hematologic malignancy specialists.

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Place of Death and Its Predictors for Local Patients Registered at a Comprehensive Cancer Center

Cited by 128 publications

References 23 publications

Factors Associated with End-of-Life Health Service Use in Patients Dying of Cancer

Factors Associated with End-of-Life Health Service Use in Patients Dying of Cancer

Clergy Views on a Good Versus a Poor Death: Ministry to the Terminally Ill

Perceptions of palliative care among hematologic malignancy specialists: A mixed-methods study.

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