scholarly journals Real-World Data on Home End-Of-Life Care for Elderly Cancer Patients: A Yokohama Original Medical Database-Based Retrospective Analysis

Author(s):  
Yukio Suzuki ◽  
Soshi Dohmae ◽  
Kohei Ohyama ◽  
Taiga Chiba ◽  
Sachiko Nakagami ◽  
...  

Abstract Background Cancer incidence is expected to increase with population aging, making the availability of places for treating terminal cancer patients a pressing issue. Thus, home medical care is expected to play a crucial role. However, real-world big data on the actual state of home end-of-life care in Japan are limited. We aimed to clarify the real-world state of home end-of-life care for elderly cancer patients using data from an administrative database. Methods We analyzed the Yokohama Original Medical Database, which included 2,486,834 people and 29,411,895 medical invoices in 2014 and 2015. Data of target patients were extracted based on three criteria: age ≥ 65 years, malignant neoplasm diagnosis, and having a billing code of home end-of-life care. Medical fee points, including data related to home medical care, emergent admission, and survival time at home, were also analyzed. Results Overall, 1,323 people (554 and 769 aged < 80 and ≥ 80 years, respectively; males, 59.2%) had planned to receive home end-of-life care. The < 80-year group had more frequent emergent home visits than the ≥ 80-year group (p < 0.001), but the number of monthly home visits was similar between the two groups (p = 0.267). The average overall survival time at home was 3.9 ± 4.4 months, with the < 80-year group having a shorter survival time than the ≥ 80-year group (p < 0.001). Conclusions Terminal cancer patients aged ≥ 80 years were less dependent on home medical care and had better prognosis at home than terminal cancer patients aged < 80 years did. Our results can provide the basis for providing home medical care through a community-based integrated care system and for evidence-based policymaking.

2014 ◽  
Vol 19 (12) ◽  
pp. 1241-1248 ◽  
Author(s):  
Chun‐Ming Chang ◽  
Chin‐Chia Wu ◽  
Wen‐Yao Yin ◽  
Shiun‐Yang Juang ◽  
Chia‐Hui Yu ◽  
...  

2013 ◽  
Vol 16 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Toshitaka Morishima ◽  
Jason Lee ◽  
Tetsuya Otsubo ◽  
Hiroshi Ikai ◽  
Yuichi Imanaka

2021 ◽  
Author(s):  
Anli Leng ◽  
Elizabeth Maitland ◽  
Siyuan Wang ◽  
Stephen Nicholas ◽  
Kuixu Lan ◽  
...  

Abstract Background Knowing terminal cancer patients’ treatment preferences will improve patient-centered health care, better inform surrogates and medical staff of patient preferences and enhance the quality of end-of-life (EoL) care. In China, little is known about terminal cancer patients’ preferences. We aimed to examines the preferences for EoL care of terminal cancer patients. Methods Data on 183 terminal cancer patients aged over 50 years old was collected by discrete choice experiment (DCE). Each DCE scenario described six attributes: hospitalization days,life extension, quality of life (QoL), adverse treatment reactions, place of death preference and out-of-pocket payments.Patient preferences were derived using a mixed logit model and the marginal willingness to pay (WTP) were estimated from the regression coefficients. Results Patients’ preferences for moderate survive time, better quality of life, lower risk of adverse reaction, home death and lower payments were all statistically significant in driving choice between treatment models. Extending life and QoL were the most important attributes. Patients were willing to pay RMB256,895.45 to improve QoL from a bad level to a very good level, significantly higher than their willingness to pay for half additional life year (RMB233,446.16) and one additional life year (RMB182,298.76). This indicates that patients were not willing to blindly pursue life extension and neglect the QoL,but preferred to trade off life extension for QoL. The predicted uptake of optimal end-of-life care scenario was 91.04%. Conclusions Our study contributes to the development of patient-centered preferences for end-of-life care models that improve advanced terminal patient’s care and provide empirical evidence for physicians and surrogates to operationalize end-of-life care trade-offs.


2007 ◽  
Vol 44 (6) ◽  
pp. 734-739
Author(s):  
Michiya Igase ◽  
Syunpei Nakamura ◽  
Masayuki Ochi ◽  
Katsuhiko Kohara ◽  
Yasunori Nagai ◽  
...  

2017 ◽  
Vol 4 (1) ◽  
pp. 35 ◽  
Author(s):  
Rudi Putranto ◽  
Laksono Trisnantoro ◽  
Yos Hendra

Pendahaluan. Meningkatnya penderita kanker terminal di Indonesia akan meningkatkan kebutuhan perawatan paliatif dan akhir kehidupan (palliative and end of life care). Pelayanan kesehatan pada pasien kanker membebani rumah sakit, karena menyebabkan biaya tinggi dan lama rawat memanjang. Penelitian ini bertujuan untuk mengevaluasi hubungan lama rawat inap dan tarif pelayanan rawat inap pasien kanker terminal dewasa dengan intervensi paliatif di Rumah Sakit dr. Cipto Mangunkusumo (RSCM).Metode. Penelitian ini adalah deskriptif analitik dengan desain kasus kontrol dan dilakukan di ruang rawat inap RSCM Jakarta selama bulan Januari–Desember 2015. Subjek adalah pasien kanker terminal dewasa di rawat inap kelas III pada tahun Januari-Desember 2015 dengan penjamin Badan Penyelenggara Jaminan Sosial (BPJS). Data diperoleh dari data rekam medis dan billing dan dianalisis menggunakan uji Mann-Whitney.Hasil. Diketahui bahwa terdapat hubungan yang signifikan antara intervensi paliatif dengan pengeluaran pasien sesuai tarif RS (p=0,041), sedangkan tidak terdapat hubungan signifikan antara intervensi paliatif dengan lama hari rawat (p=0,873). Terdapat hubungan bermakna antara intervensi paliatif dan tarif pengeluaran kamar, visite, tindakan dan obat dan intervensi paliatif.Simpulan. Terdapat hubungan yang signifikan antara intervensi paliatif dengan pengeluaran pasien sesuai tarif RS. Terdapat hubungan bermakna antara intervensi paliatif dan tarif pengeluaran kamar, visite, tindakan dan obat dan intervensi paliatif.Kata Kunci: intervensi, lama rawat, perawatan paliatif, tarif Cost of Care Saving of Terminal Cancer Adult Patient Using Palliative Care Consultation in Cipto Mangunkusumo HospitalIntroduction. Terminal cancer patients was increasing in Indonesia, and need attention to approach palliative and end of life care. Terminal cancer management was burden the hospital, because it causes high costly and the length of stay This study aimed to get a general picture of service palliative at Cipto Mangunkusumo, then to evaluate the relationship hospitalization and rates of inpatient services people with terminal cancer adults who received the intervention palliative care and to evaluate the relationship variable rates for accommodation (room), doctor visit, procedure/surgery, medicines and consumables, laboratory and radiology to palliative interventions in patients with terminal cancer in inpatient Dr. Cipto Mangunkusumo Hospital. Methods. This research was descriptive study with case control design and performed in the inpatient unit, Dr Cipto Mangunkusumo Hospital, during the month of January to December 2015. The subjects were medical records and billing of terminal cancer patients were .hospitalized adults in class III in January - December 2015 with National Health Insurance (BPJS). Inclusion criteria are terminal cancer patients, beusia ≥ 18 years, received palliative care consultation team while exclusion criteria are patients receiving palliative consultation on treatment days ≥ 25 days.Results. It is known that there is a significant relationship between palliative interventions to patients with hospital rates (p= 0.041), whereas there was no significant relationship between palliative interventions by the length of stay (p = 0.873). There is a significant relationship between palliative interventions and expenditures room rates, visite, action and medicine and palliative interventions.Conclusions. There is a significant relationship between palliative interventions with hospital rates. There is a significant relationship between palliative interventions and expenditures room rates, visite, action and medicine and palliative interventions. These data showed that palliative care intervention was saving money for hospital. 


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