To describe trends in the aggressiveness of end-of-life (EOL) cancer care in a universal health care system in Ontario, Canada, between 1993 and 2004, and to compare with findings reported in the United States.
A population-based, retrospective, cohort study that used administrative data linked to registry data. Aggressiveness of EOL care was defined as the occurrence of at least one of the following indicators: last dose of chemotherapy received within 14 days of death; more than one emergency department (ED) visit within 30 days of death; more than one hospitalization within 30 days of death; or at least one intensive care unit (ICU) admission within 30 days of death.
Among 227,161 patients, 22.4% experienced at least one incident of potentially aggressive EOL cancer care. Multivariable analyses showed that with each successive year, patients were significantly more likely to encounter some aggressive intervention (odds ratio, 1.01; 95% CI, 1.01 to 1.02). Multiple emergency department (ED) visits, ICU admissions, and chemotherapy use increased significantly over time, whereas multiple hospital admissions declined (P
Cites: Natl Vital Stat Rep. 2009 Dec 23;58(8):1-9720361522
Cites: J Clin Oncol. 2009 Jun 20;27(18):3052-819451437
Cites: N Engl J Med. 2010 Aug 19;363(8):733-4220818875
Cites: J Clin Oncol. 2004 Jan 15;22(2):315-2114722041
Cites: J Clin Oncol. 2003 Mar 15;21(6):1133-812637481