Abstract
Acute care hospitals have a role in managing the health care needs of people affected by cancer when they are at the end of life. However, there is a need to provide end-of-life care in other settings, including at home or in hospice, when such settings are more appropriate. Using data from 9 provinces, we examined indicators that describe the current landscape of acute care hospital use at the end of life for patients who died of cancer in hospital in Canada. Interprovincial variation was observed in acute care hospital deaths, length of stay in hospital, readmission to hospital, and intensive care unit use at the end of life. High rates of acute care hospital use near the end of life might suggest that community and home-based end-of-life care might not be suiting patient needs.
Highlights
The World Health Organization defines palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with lifethreatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual”[1]
Records for cancer patients who died in acute care hospitals were extracted based on the Discharge Abstract Database provided by the Canadian Institute for Health Information, which collects data for separations with a discharge date between 1 April and 31 March of a given fiscal year
Cancer Patients Dying in Acute Care Hospitals
Summary
The World Health Organization defines palliative care as “an approach that improves the quality of life of patients and their families facing the problems associated with lifethreatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual”[1]. Palliative care has been shown to significantly improve patient outcomes and quality of life in the domains of pain, anxiety, and symptom control[5,6]. Those results all suggest that palliative care can optimize patient outcomes and greatly affect the use of health services. Admission to an acute care hospital could be appropriate for many cancer patients because of disease progression or because of a need for optimal management of treatment complications or for intensive care. Overuse of acute hospital care could signal that available outpatient, primary, or community care might not be addressing patient needs, but might indicate a potential gap in palliative care services
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