Chronic obstructive pulmonary disease and lung cancer: access to palliative care, emergency room visits and hospital deaths.
Adult
Aged
Aged, 80 and over
Death
Emergency Service, Hospital
/ statistics & numerical data
Female
Hospitals
Humans
Logistic Models
Lung Neoplasms
Male
Middle Aged
Multivariate Analysis
Palliative Care
/ statistics & numerical data
Pulmonary Disease, Chronic Obstructive
Registries
Retrospective Studies
Young Adult
Chronic obstructive pulmonary disease
Lung cancer
Palliative care services
Place of death
Journal
BMC pulmonary medicine
ISSN: 1471-2466
Titre abrégé: BMC Pulm Med
Pays: England
ID NLM: 100968563
Informations de publication
Date de publication:
19 May 2021
19 May 2021
Historique:
received:
09
03
2021
accepted:
07
05
2021
entrez:
20
5
2021
pubmed:
21
5
2021
medline:
19
11
2021
Statut:
epublish
Résumé
Despite the severe symptoms experienced by dying COPD patients, specialized palliative care (SPC) services focus mainly on cancer patients. We aimed to study the access to SPC that COPD and lung cancer (LC) patients receive and how that access affects the need for acute hospital care. A descriptive regional registry study using data acquired through VAL, the Stockholm Regional Council's central data warehouse, which covers nearly all healthcare use in the county of Stockholm. All the patients who died of COPD or LC from 2015 to 2019 were included. T-tests, chi-2 tests, and univariable and multivariable logistic regression analyses were performed on the accumulated data. In total, 6479 patients, (2917 with COPD and 3562 with LC) were studied. The patients with LC had more access to SPC during the last three months of life than did those with COPD (77% vs. 18%, respectively; p < .0001), whereas patients with COPD were more likely to be residents of nursing homes than those with LC (32% vs. 9%, respectively; p < .0001). Higher socioeconomic status (SES) (p < .01) and patient age < 80 years (p < .001) were associated with increased access to SPC for LC patients. Access to SPC correlated with fewer emergency room visits (p < .0001 for both COPD and LC patients) and fewer admissions to acute hospitals during the last month of life (p < .0001 for both groups). More COPD patients died in acute hospitals than lung cancer patients, (39% vs. 20%; χ Compared to dying COPD patients, LC patients have more access to SPC. Access to SPC reduces the need for emergency room visits and admissions to acute hospitals.
Sections du résumé
BACKGROUND
BACKGROUND
Despite the severe symptoms experienced by dying COPD patients, specialized palliative care (SPC) services focus mainly on cancer patients. We aimed to study the access to SPC that COPD and lung cancer (LC) patients receive and how that access affects the need for acute hospital care.
METHODS
METHODS
A descriptive regional registry study using data acquired through VAL, the Stockholm Regional Council's central data warehouse, which covers nearly all healthcare use in the county of Stockholm. All the patients who died of COPD or LC from 2015 to 2019 were included. T-tests, chi-2 tests, and univariable and multivariable logistic regression analyses were performed on the accumulated data.
RESULTS
RESULTS
In total, 6479 patients, (2917 with COPD and 3562 with LC) were studied. The patients with LC had more access to SPC during the last three months of life than did those with COPD (77% vs. 18%, respectively; p < .0001), whereas patients with COPD were more likely to be residents of nursing homes than those with LC (32% vs. 9%, respectively; p < .0001). Higher socioeconomic status (SES) (p < .01) and patient age < 80 years (p < .001) were associated with increased access to SPC for LC patients. Access to SPC correlated with fewer emergency room visits (p < .0001 for both COPD and LC patients) and fewer admissions to acute hospitals during the last month of life (p < .0001 for both groups). More COPD patients died in acute hospitals than lung cancer patients, (39% vs. 20%; χ
CONCLUSIONS
CONCLUSIONS
Compared to dying COPD patients, LC patients have more access to SPC. Access to SPC reduces the need for emergency room visits and admissions to acute hospitals.
Identifiants
pubmed: 34011344
doi: 10.1186/s12890-021-01533-3
pii: 10.1186/s12890-021-01533-3
pmc: PMC8132345
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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