Abstract
metastatic disease (1.36 [1.27–1.46]), and survived <1 year but longer than 2 months post-diagnosis. The propensity for continued chemotherapy in patients’ last month was significantly increased by being cared for by a medical oncologist (3.49 [3.04–3.99]) or in a teaching hospital (1.39 [1.11– 1.74]) and with the highest intensity of total inpatient hospital beds (1.63 [0.99–2.68]) but was not influenced by regional healthcare resources (total hospital and hospice beds). Conclusion: The propensity to continue chemotherapy in the last month of life was determined by patient demographics and disease characteristics, physician specialty, and healthcare resources at the primary hospital level. Maintaining a delicate balance between deciding to continue chemotherapy and starting palliative care remains a challenge. However, appropriate discussion of transition from curative to palliative care may minimize the over-estimated effectiveness of chemotherapy to achieve end-of-life care that best meets cancer patients’ needs and preferences.
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