Delivery of health care at the end of life in cancer patients of four swiss cantons: a retrospective database study (SAKK 89/09)

BMC Cancer

Klazien W Matter-Walstra⁵  Rita Achermann³  Roland Rapold³  Dirk Klingbiel⁵  Andrea Bordoni⁴  Silvia Dehler²  Gernot Jundt¹  Isabelle Konzelmann⁶  Kerri M Clough-Gorr⁸  Thomas D Szucs³  Matthias Schwenkglenks⁹  Bernhard C Pestalozzi⁷ 

[1] Cancer Registry Basel-Stadt and Basel-Land, University Hospital Basel Basel, Switzerland

[2] Cancer Registry Zürich and Zug, University Hospital Zürich Zürich, Switzerland

[3] Helsana Group, Zürich, Switzerland

[4] Cancer Registry Ticino Locarno, Switzerland

[5] Swiss Group for Clinical Cancer Research (SAKK) Bern, Switzerland

[6] Cancer Registry Valais Sion, Switzerland

[7] Division of Oncology, University Hospital Zürich Zürich, Switzerland

[8] Institute of Social and Preventative Medicine (ISPM), University of Bern Bern, Switzerland

[9] Institute of Pharmaceutical Medicine (ECPM), University of Basel Basel, Switzerland

关键词: Hospitalization;    Health insurance;    Chemotherapy;    Radiotherapy;    End-of-life;    Cancer;   

Others  :  858852
DOI  :  10.1186/1471-2407-14-306

 received in 2013-07-16, accepted in 2014-04-23,  发布年份 2014

【 摘 要 】

Background

The use of cancer related therapy in cancer patients at the end-of-life has increased over time in many countries. Given a lack of published Swiss data, the objective of this study was to describe delivery of health care during the last month before death of cancer patients.

Methods

Claims data were used to assess health care utilization of cancer patients (identified by cancer registry data of four participating cantons), deceased between 2006-2008. Primary endpoints were hospitalization rate and delivery of cancer related therapies during the last 30 days before death. Multivariate logistic regression assessed the explanatory value of patient and geographic characteristics.

Results

3809 identified cancer patients were included. Hospitalization rate (mean 68.5%, 95% CI 67.0-69.9) and percentage of patients receiving anti-cancer drug therapies (ACDT, mean 14.5%, 95% CI 13.4-15.6) and radiotherapy (mean 7.7%, 95% CI 6.7-8.4) decreased with age. Canton of residence and insurance type status most significantly influenced the odds for hospitalization or receiving ACDT.

Conclusions

The intensity of cancer specific care showed substantial variation by age, cancer type, place of residence and insurance type status. This may be partially driven by cultural differences within Switzerland and the cantonal organization of the Swiss health care system.

【 授权许可】

   
2014 Matter-Walstra et al.; licensee BioMed Central Ltd.

【 图 表 】

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