[End-of-life therapy for patients dying with cancer: a retrospective database study].

BACKGROUND: The topic of "medical oversupply at the end-of-life" is being discussed intensively internationally. The aim of this paper is to present the data of end-of-life care in one region in Austria (Lower Austria).
METHODS: The data basis for the end-of-life indicators was the routine data (secondary data analysis) of the Lower Austrian District Health Insurance Fund (NÖGKK) from 2015. The basic population consisted of persons with inpatient hospitalization with a cancer diagnosis. Primary endpoints included place of death and time of death, hospital admission, and special end-of-life therapies (30 days before death). NÖGKK insured persons older than 16 years and a subpopulation older than 65 years were evaluated.
RESULTS: 2788 cancer patients (NÖGKK insured) were included. 61.1% died in a hospital, 17.9% of them on the day of admission. In 16.2% of all patients, death occurred on a palliative care unit, 9.3% died in an intensive care unit. The hospitalization rate 30 days before death was 61.6%. Hospital admission was more common in men than in women. 9.4% of total deaths received chemotherapy, radiotherapy, or monoclonal antibodies within the last 30 days.
CONCLUSIONS: In international comparison, the region of Lower Austria shows very high hospital admission and hospital mortality rates. Further investigations for the entire country (all regions) are therefore desirable. The establishment of a discussion about the medical oversupply at the end-of-life in Austria, including appropriate care concepts and care models, is needed.