| アブストラクト | BACKGROUND: End-of-life (EOL) cancer care in Japanese acute care hospitals has not been well described. METHODS: We aimed to assess the aggressiveness of EOL care and examine common treatments administered to cancer patients using a health administrative database. Subjects are adult cancer patients who died at acute care hospitals between April 2011 and March 2014. Data from the Japanese Diagnosis Procedure Combination database were analysed to measure the aggressiveness of care (chemotherapy, intensive care unit [ICU] admission and cardiopulmonary resuscitation [CPR]) and describe procedures and prescriptions administered in the last 14 and 30 days of life, disaggregated by hospital case volume: high, intermediate and low volumes. RESULTS: Of 248,978 cancer decedents, 170,024 died in high-, 70,231 in intermediate- and 8,723 in low-volume hospitals. Aggressive treatment in the last 14 days of life included chemotherapy (9.4%, 7.3%, and 5.4%, respectively), ICU admission (3.0%, 2.0%, and 2.4%) and CPR (5.8%, 6.4%, and 8.3%). Opioids were administered to 66.0%, 59.0% and 49.4% patients, while Palliative Care Team intervention was performed for 8.5%, 2.2% and 2.0% of patients, respectively in the last 30 days. In high-volume hospitals, radiotherapy and certified outpatient chemotherapy fees were more frequent. Catecholamines and hyperalimentation were more frequently administered in low-volume hospitals. CONCLUSION: This is the first study to assess EOL care among Japanese acute care hospitals. More frequent use of chemotherapy at high-volume hospitals may reflect a well-established cancer treatment system. The approach for low-volume hospitals might improve the EOL care for all cancer patients in Japan. |
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| ジャーナル名 | Japanese journal of clinical oncology |
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| 投稿日 | 2018/8/15 |
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| 投稿者 | Sato, Yuko; Miyashita, Mitsunori; Sato, Kazuki; Fujimori, Kenji; Ishikawa, Koichi Benjamin; Horiguchi, Hiromasa; Fushimi, Kiyohide; Ishioka, Chikashi |
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| 組織名 | Department of Clinical Oncology, Institute of Development, Aging and Cancer,;Tohoku University, Sendai, Japan.;Department of Palliative Nursing, Health Sciences, Tohoku University Graduate;School of Medicine, Sendai, Japan.;Department of Health Administration and Policy, Tohoku University Graduate School;of Medicine.;Clinical Economics Section, Center for Public Health Sciences, National Cancer;Center.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/30107588/ |
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