Abstract：
CONTEXT:The impact of hospice care services on the utilization of life-sustaining treatments during end-of-life care in terminally ill patients has not been extensively studied. OBJECTIVES:To determine the impact of hospice care services on the utilization of life-sustaining treatments during the last three months of life among patients with cancer. METHODS:This nationwide population-based cohort study identified adults with cancer diagnosis from the Taiwan Registry for Catastrophic Illness, 2006-2016. Life-sustaining treatments included cardiopulmonary resuscitation, intubation, mechanical ventilation support, nasogastric tube feeding, and total parenteral nutrition. Hospice care services consisted of hospice inpatient care, hospice-shared care, and hospice home care. The association of hospice care services with the utilization of life-sustaining treatments was determined using multiple logistic regression. RESULTS:Of 516,409 patients with cancer, 310,722 (60.2%) patients used life-sustaining treatments during the last three months of life. After adjusting for covariates, patients with hospice care services were less likely to receive life-sustaining treatments during the last three months of life than those without the services (adjusted odds ratio [AOR]: 0.70; 95% CI: 0.69-0.71). While type of life-sustaining treatments were considered, hospice care services were associated with a lower likelihood of receiving cardiopulmonary resuscitation (AOR: 0.125; 95% CI: 0.118-0.131), endotracheal intubation (AOR: 0.204; 95% CI: 0.199-0.210), mechanical ventilation support (AOR: 0.265; 95% CI: 0.260-0.270), nasogastric tube feeding (AOR: 0.736; 95% CI: 0.727-0.744), and total parenteral nutrition (AOR: 0.86; 95% CI: 0.84-0.88). CONCLUSION:Hospice care services were associated with a lower likelihood of receiving life-sustaining treatments during the last three months of life in patients with cancer.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Yen YF,Lai YJ,Ko MC,Chen YY,Chen YT,Chou YS,Huang CT,Chen CCdoi
10.1016/j.jpainsymman.2020.07.028subject
Has Abstractpub_date
2021-02-01 00:00:00pages
323-330issue
2eissn
0885-3924issn
1873-6513pii
S0885-3924(20)30640-0journal_volume
61pub_type
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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doi：10.1016/j.jpainsymman.2020.10.025
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,随机对照试验
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
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journal_title：Journal of pain and symptom management
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