Yu-Han Chen1,2, Chung-Han Ho3,4, Chien-Cheng Huang5,6,7,8, Ya-Wen Hsu3,4, Yueh-Chun Chen1,9, Ping-Jen Chen1,6,8, Guan-Ting Chen1,10, Jhi-Joung Wang3,10. 1. Palliative Care Center, Chi-Mei Medical Center, Tainan, Taiwan. 2. Department of Family Medicine, Chi-Mei Medical Center, Tainan, Taiwan. 3. Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan. 4. Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. 5. Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan. 6. Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan. 7. Department of Environmental and Occupational Health, College of Medicine National Cheng Kung University, Tainan, Taiwan. 8. Bachlor Program of Senior Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan. 9. Department of Nursing, Chi-Mei Medical Center, Tainan, Taiwan. 10. Department of Anesthesiology, Chi-Mei Medical Center, Tainan, Taiwan.
Abstract
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared. RESULTS: Of the 2724 patients enrolled, 908 had dementia and 1816 had cancer. PwD were more likely to have a higher frequency of admission to hospital and intensive care unit, and longer stays compared with cancer patients. PwD had a higher risk of enteral tube insertion and feeding, endotracheal intubation and tracheostomy, mechanical ventilation, hemodialysis and cardiopulmonary resuscitation (OR 4.36, 95% CI 3.51-5.41), which was the highest among the selected procedures. CONCLUSIONS: PwD in their last year of life in Taiwan underwent aggressive interventions significantly more frequently than did their counterparts in Western countries. Providing comfort-centered care for better quality of life for end-of-life PwD is a priority of Taiwan's national health policy. Geriatr Gerontol Int 2017; 17: 2545-2551.
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancerpatients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared. RESULTS: Of the 2724 patients enrolled, 908 had dementia and 1816 had cancer. PwD were more likely to have a higher frequency of admission to hospital and intensive care unit, and longer stays compared with cancerpatients. PwD had a higher risk of enteral tube insertion and feeding, endotracheal intubation and tracheostomy, mechanical ventilation, hemodialysis and cardiopulmonary resuscitation (OR 4.36, 95% CI 3.51-5.41), which was the highest among the selected procedures. CONCLUSIONS: PwD in their last year of life in Taiwan underwent aggressive interventions significantly more frequently than did their counterparts in Western countries. Providing comfort-centered care for better quality of life for end-of-life PwD is a priority of Taiwan's national health policy. Geriatr Gerontol Int 2017; 17: 2545-2551.
Authors: Ping-Jen Chen; Chung-Han Ho; Jung-Yu Liao; Lisanne Smits; Chao A Hsiung; Sang-Ju Yu; Kai-Ping Zhang; Irene Petersen; Elizabeth L Sampson Journal: Int J Environ Res Public Health Date: 2020-12-10 Impact factor: 3.390
Authors: Yu-Han Chen; Yi-Chen Lai; Yu-Cih Wu; Jun Sasaki; Kang-Ting Tsai; Chung-Han Ho Journal: Int J Environ Res Public Health Date: 2021-05-26 Impact factor: 3.390