Decreased aggressive care at the end of life among advanced cancer patients in the Republic of Korea: a nationwide study from 2012 to 2018.

IF 2.5 2区 医学 Q2 HEALTH CARE SCIENCES & SERVICES BMC Palliative Care Pub Date : 2024-06-25 DOI:10.1186/s12904-024-01459-7
Sara Kwon, Kyuwoong Kim, Bohyun Park, So-Jung Park, Hyun Jung Jho, Jin Young Choi
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Abstract

Background: This study aimed to investigate the trends of aggressive care at the end-of-life (EoL) for patients with advanced cancer in Korea and to identify factors affecting such care analyzing nationwide data between 2012 to 2018.

Methods: This was a population-based, retrospective nationwide study. We used administrative data from the National Health Insurance Service and the Korea Central Cancer Registry to analyze 125,350 patients aged 20 years and above who died within one year of a stage IV cancer diagnosis between 2012 and 2018.

Results: The overall aggressiveness of EoL care decreased between 2012 and 2018. In patients' last month of life, chemotherapy use (37.1% to 32.3%; p < 0.05), cardiopulmonary resuscitation (13.2% to 10.4%; p < 0.05), and intensive care unit admission (15.2% to 11.1%; p < 0.05) decreased during the study period, although no significant trend was noted in the number of emergency room visits. A steep increase was seen in inpatient hospice use in the last month of life (8.6% to 26.6%; p < 0.05), while downward trends were observed for hospice admission within three days prior to death (13.9% to 11%; p < 0.05). Patients were more likely to receive aggressive EoL care if they were younger, women, had treatment in tertiary hospitals, or had hematologic malignancies. In the subgroup analysis, the overall trend of aggressive EoL care decreased for all five major cancer types.

Conclusion: The aggressiveness of EoL care in stage IV cancer patients showed an overall decrease during 2012-2018 in Korea.

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大韩民国晚期癌症患者生命末期积极护理的减少:2012年至2018年全国性研究。
研究背景本研究旨在调查韩国晚期癌症患者临终前积极护理的趋势,并通过分析2012年至2018年期间的全国数据,找出影响此类护理的因素:这是一项基于人群的全国性回顾性研究。我们利用国民健康保险服务局和韩国中央癌症登记处的行政数据,分析了2012年至2018年间125350名年龄在20岁及以上、确诊为IV期癌症后一年内死亡的患者:2012年至2018年间,EoL护理的整体积极性有所下降。在患者生命的最后一个月,化疗的使用率(37.1%降至32.3%;P 结论:在2012年至2018年期间,EoL护理的整体积极性有所下降:2012年至2018年期间,韩国IV期癌症患者生活护理的积极性总体下降。
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来源期刊
BMC Palliative Care
BMC Palliative Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
4.60
自引率
9.70%
发文量
201
审稿时长
21 weeks
期刊介绍: BMC Palliative Care is an open access journal publishing original peer-reviewed research articles in the clinical, scientific, ethical and policy issues, local and international, regarding all aspects of hospice and palliative care for the dying and for those with profound suffering related to chronic illness.
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