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- Title
Reduction in potentially inappropriate end-of-life hospital care for cancer patients during the COVID-19 pandemic: A retrospective population-based study.
- Authors
Slotman, Ellis; Fransen, Heidi P; van Laarhoven, Hanneke WM; van den Beuken-van Everdingen, Marieke HJ; Tjan-Heijnen, Vivianne CG; Huijben, Auke MT; Jager, Agnes; van Zuylen, Lia; Kuip, Evelien JM; van der Linden, Yvette M; Raijmakers, Natasja JH; Siesling, Sabine
- Abstract
Background: The COVID-19 pandemic impacted cancer diagnosis and treatment. However, little is known about end-of-life cancer care during the pandemic. Aim: To investigate potentially inappropriate end-of-life hospital care for cancer patients before and during the COVID-19 pandemic. Design: Retrospective population-based cohort study using data from the Netherlands Cancer Registry and the Dutch National Hospital Care Registration. Potentially inappropriate care in the last month of life (chemotherapy administration, >1 emergency room contact, >1 hospitalization, hospitalization >14 days, intensive care unit admission or hospital death) was compared between four COVID-19 periods and corresponding periods in 2018/2019. Participants: A total of 112,919 cancer patients (⩾18 years) who died between January 2018 and May 2021 were included. Results: Fewer patients received potentially inappropriate end-of-life care during the COVID-19 pandemic compared to previous years, especially during the first COVID-19 peak (22.4% vs 26.0%). Regression analysis showed lower odds of potentially inappropriate end-of-life care during all COVID-19 periods (between OR 0.81; 95% CI 0.74–0.88 and OR 0.92; 95% CI 0.87–0.97) after adjustment for age, sex and cancer type. For the individual indicators, fewer patients experienced multiple or long hospitalizations, intensive care unit admission or hospital death during the pandemic. Conclusions: Cancer patients received less potentially inappropriate end-of-life care during the COVID-19 pandemic. Because several factors may have contributed, it is unclear whether this reflects better quality care. However, these findings raise important questions about what pandemic-induced changes in care practices can help provide appropriate end-of-life care for future patients in the context of increasing patient numbers and limited resources.
- Subjects
NETHERLANDS; HOSPITALS; INTENSIVE care units; CONFIDENCE intervals; TERMINAL care; RETROSPECTIVE studies; PATIENTS; REGRESSION analysis; MEDICAL errors; CANCER patients; HOSPITAL admission &; discharge; HOSPITAL mortality; HOSPITAL care; DESCRIPTIVE statistics; CHI-squared test; RESEARCH funding; ODDS ratio; LOGISTIC regression analysis; DATA analysis software; PATIENT safety; PALLIATIVE treatment; COVID-19 pandemic; LONGITUDINAL method
- Publication
Palliative Medicine, 2024, Vol 38, Issue 1, p140
- ISSN
0269-2163
- Publication type
Article
- DOI
10.1177/02692163231217373