Reduction in potentially inappropriate end-of-life hospital care for cancer patients during the COVID-19 pandemic: A retrospective population-based study

Reduction in potentially inappropriate end-of-life hospital care for cancer patients during the COVID-19 pandemic: A retrospective population-based study

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: Retrospe...

Full description

Saved in:
Bibliographic Details
Published in:Palliative medicine Vol. 38; no. 1; pp. 140 - 149
Main 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
Format: Journal Article
Language:English
Published: London, England SAGE Publications 01-01-2024
Sage Publications Ltd
Subjects:
Cancer
Chemotherapy
Cohort analysis
COVID-19
Death & dying
End of life decisions
Hospice care
Hospitalization
Inappropriateness
Intensive care
Medical diagnosis
Palliative care
Pandemics
Patients
Quality of care
COVID-19
cohort studies
terminal care
neoplasms
palliative care
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0269-2163
1477-030X
DOI:10.1177/02692163231217373