• S T Tang, S-C Wu, Y-N Hung, E-W Huang, J-S Chen, and T-W Liu.
• Graduate School of Nursing, Chang Gung University and Department of Nursing, Kaohsiung Chung Gung Memorial Hospital, Taoyuan. sttang@mail.cgu.edu.tw
• Ann. Oncol. 2009 Feb 1;20(2):343-8.

BackgroundQuality of end-of-life care received by cancer patients has never been explored in an entire Asian country for all ages and cancer groups.Patients And MethodsRetrospective cohort study to examine trends in quality of end-of-life care among a cohort of 242 530 Taiwanese cancer patients who died in 2000-2006.ResultsIn the last month of life, cancer care tended to become increasingly aggressive as shown by (i) intensive use of chemotherapy (15.45%-17.28%), (ii) frequent emergency room visits (15.69%-20.99%) and >14-day hospital stays (41.48%-46.20%), (iii) admissions to intensive care units (10.04%-12.41%), and (iv) hospital deaths (59.11%-65.40%). Use of cardiopulmonary resuscitation (13.09%-8.41%), intubation (26.01%-21.07%), and mechanical ventilation (27.46%-27.05%) decreased, whereas use of hospice services increased considerably (7.34%-16.83%). Among those receiving hospice services, rates of referrals to hospice services in the last 3 days of life decreased from 17.88% to 17.13% but remained steady after adjusting for selected covariates.ConclusionsThe quality of end-of-life care for Taiwanese cancer decedents was substantially inferior to that previously reported and to that recommended as benchmarks for not providing overly aggressive care near the end of life.

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