國家衛生研究院 NHRI:Item 3990099045/4594
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    题名: Performance of medical oncologists on end-of-life care for Taiwanese cancer decedents, 2001-2006
    作者: Tang, S;Liu, TW;Chen, JS;Wang, HM;Wu, SC;Hung, YN
    贡献者: National Institute of Cancer Research
    摘要: Background: Oncologists play a significant role in cancer care throughout the cancer trajectory and have traditionally emphasized underuse of procedures or treatments with well-established effectiveness as the source of poor care quality with little attention to the overuse of end-of-life (EOL)care. The purpose of this population-based study was to compare EOL care practices in Taiwan between medical oncologists and other physician specialists. Methods: This retrospective cohort study compared indicators of poor quality EOL care by examining administrative data for a cohort of 204,850cancer decedents in 2001–2006.Results: Taiwanese cancer patients whose primary physician was a medical oncologist were significantly more likely than patients with a non-oncologist primary physician to receive chemotherapy (AOR: 3.45, 95% CI:3.03−4.00) and to spend more than 14 days in a hospital (AOR: 1.11,95% CI: 1.04−1.19) in the last month of life. However, they were significantly less likely than patients with a non-oncologist primary physician to visit the ER more than once (AOR: 0.88, 95% CI: 0.81−0.96), and to use ICU care (AOR: 0.32, 95% CI: 0.22−0.48), cardiopulmonary resuscitation(CPR) (AOR: 0.71, 95% CI: 0.64−0.80), intubation (AOR: 0.60, 95% CI:0.51−0.70), and mechanical ventilation (AOR: 0.46, 95% CI: 0.39−0.54) in the last month of life. Conclusion: Cancer decedents cared for by medical oncologists had a greater likelihood of receiving chemotherapy and prolonged hospitalization but a lower propensity for multiple ER visits, ICU care, and undergoing CPR, intubation, and mechanical ventilation in the last month of life than patients with other types of physicians.
    日期: 2009-09
    關聯: EJC Supplements. 2009 Sep;7(2):179.
    Link to: http://dx.doi.org/10.1016/S1359-6349(09)70612-3
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000270645900603
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