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Hospitalisation at the end of life among cancer and non-cancer patients in Denmark: a nationwide register-based cohort study.


ABSTRACT:

Objectives

End-of-life hospitalisations may not be associated with improved quality of life. Studies indicate differences in end-of-life care for cancer and non-cancer patients; however, data on hospital utilisation are sparse. This study aimed to compare end-of-life hospitalisation and place of death among patients dying from cancer, heart failure or chronic obstructive pulmonary disease (COPD).

Design

A nationwide register-based cohort study.

Setting

Data on all in-hospital admissions obtained from nationwide Danish medical registries.

Participants

All decedents dying from cancer, heart failure or COPD disease in Denmark between 2006 and 2015.

Outcome measures

Data on all in-hospital admissions within 6?months and 30 days before death as well as place of death. Comparisons were made according to cause of death while adjusting for age, sex, comorbidity, partner status and residential region.

Results

Among 154?235 decedents, the median total bed days in hospital within 6?months before death was 19 days for cancer patients, 10 days for patients with heart failure and 11 days for patients with COPD. Within 30 days before death, this was 9 days for cancer patients, and 6 days for patients with heart failure and COPD. Compared with cancer patients, the adjusted relative bed day use was 0.65 (95% CI, 0.63 to 0.68) for heart failure patients and 0.68 (95% CI, 0.66 to 0.69) for patients with COPD within 6?months before death. Correspondingly, this was 0.65 (95% CI, 0.63 to 0.68) and 0.70 (95% CI, 0.68 to 0.71) within 30 days before death.Patients had almost the same risk of dying in hospital independently of death cause (46.2% to 56.0%).

Conclusion

Patients with cancer, heart failure and COPD all spent considerable part of their end of life in hospital. Hospital use was highest among cancer patients; however, absolute differences were small.

SUBMITTER: Vestergaard AHS 

PROVIDER: S-EPMC7322325 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Publications

Hospitalisation at the end of life among cancer and non-cancer patients in Denmark: a nationwide register-based cohort study.

Vestergaard Anne Høy Seemann AHS   Neergaard Mette Asbjoern MA   Christiansen Christian Fynbo CF   Nielsen Henrik H   Lyngaa Thomas T   Laut Kristina Grønborg KG   Johnsen Søren Paaske SP  

BMJ open 20200628 6


<h4>Objectives</h4>End-of-life hospitalisations may not be associated with improved quality of life. Studies indicate differences in end-of-life care for cancer and non-cancer patients; however, data on hospital utilisation are sparse. This study aimed to compare end-of-life hospitalisation and place of death among patients dying from cancer, heart failure or chronic obstructive pulmonary disease (COPD).<h4>Design</h4>A nationwide register-based cohort study.<h4>Setting</h4>Data on all in-hospit  ...[more]

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