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Comparison of healthcare utilization and life-sustaining interventions between elderly patients with dementia and those with cancer near the end of life: A nationwide, population-based study in Taiwan

Chen, Y-H; Ho, C-H; Huang, C-C; Hsu, Y-W; Chen, Y-C; Chen, P-J; Chen, G-T; (2017) Comparison of healthcare utilization and life-sustaining interventions between elderly patients with dementia and those with cancer near the end of life: A nationwide, population-based study in Taiwan. Geriatrics and Gerontology International , 17 (12) pp. 2545-2551. 10.1111/ggi.13084. Green open access

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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.

Type: Article
Title: Comparison of healthcare utilization and life-sustaining interventions between elderly patients with dementia and those with cancer near the end of life: A nationwide, population-based study in Taiwan
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/ggi.13084
Publisher version: https://doi.org/10.1111/ggi.13084
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: cancer dementia, end‐of‐life, life‐sustaining, treatment, utilization
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10070644
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