Cancer and end of life: the management provided during the year and the month preceding death in 2015 and causes ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-12-16

AUTHORS

Audrey Tanguy Melac, Thomas Lesuffleur, Philippe-Jean Bousquet, Anne Fagot-Campagna, Christelle Gastaldi-Ménager, Philippe Tuppin

ABSTRACT

PurposeThe management of cancer patients at the end of life in France and their causes of death are not well known.MethodsPeople managed for cancer in 2014–2015, who died in 2015 and who were covered by the national health insurance general scheme (77% of the French population) were selected from the national health data system in order to analyze the health care reimbursed during the year and the month before their death.ResultsThis study included 125,497 people (mean age 73 years, SD 12.5) managed for cancer: colorectal: 12%, lung: 18%, prostate: 9%, breast: 8% and other: 62%. Almost 67% of people died in short-stay hospitals (SSH), 8% died in rehabilitation units (Rehab), 4% died in hospital at home (HaH), 5% died in skilled nursing homes (SNH) and 15% died at home or another place. The mean annual duration of all types of hospitalization was 70 days (SD 66) and 59% of patients had received hospital palliative care (HPC). During the last month of life, 42% of people had attended an emergency department at least once and people who had received HPC were less often admitted to an intensive care unit (10% versus 23%, 15% overall). During the month before death, 17% of patients had received intravenous chemotherapy (lung 23%, breast 21%) and 9% had received a pharmacy reimbursement for another form of chemotherapy (prostate 24%, breast 19%). The main cause of death was a tumour for 81% of patients: after management of lung cancer in 91% of cases, breast cancer in 81% of cases, colorectal cancer in 76% of cases and prostate cancer in 63% of cases.ConclusionsCancer management and death mostly occurred in SSH in France. Cancer patients frequently attend the emergency department and frequently receive chemotherapy during the last month of life. These data continue to contrast with those observed in Scandinavian- and English-speaking countries, in which management of the end of life at home is preferred. More... »

PAGES

3877-3887

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00520-019-05188-z

DOI

http://dx.doi.org/10.1007/s00520-019-05188-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1123439405

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31845006


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