End-of-life care at a community cancer center

David E. Cowall, Bennett W. Yu, Sandra Heineken, Elizabeth N. Lewis, Vishal Chaudhry, Joan M. Daugherty

Research output: Contribution to journalArticle

Abstract

Purpose: The evidence-based use of resources for cancer care at end of life (EOL) has the potential to relieve suffering, reduce health care costs, and extend life. Internal benchmarks need to be established within communities to achieve these goals. The purpose for this study was to evaluate data within our community to determine our EOL cancer practices. Methods: A random sample of 390 patients was obtained from the 942 cancer deaths in Wicomico County, Maryland, for calendar years 2004 to 2008. General demographic, clinical event, and survival data were obtained from that sample using cancer registry and hospice databases as well as manual medical record reviews. In addition, the intensity of EOL cancer care was assessed using previously proposed indicator benchmarks. The significance of potential relationships between variables was explored using χ2 analyses. Results: Mean age at death was 70 years; 52% of patients were male; 34% died as a result of lung cancer. Median survival from diagnosis to death was 8.4 months with hospice admission and 5.8 months without hospice (P = .11). Four of eight intensityof-care indicators (ie, intensive care unit [ICU] admission within last month of life, > one hospitalization within last month of life, hospital death, and hospice referral < 3 days before death) all significantly exceeded the referenced benchmarks. Hospice versus nonhospice admissions were associated (P < .001) with ICU admissions (2% v 13%) and hospital deaths (2% v 54%). Conclusion: These data suggest opportunities to improve community cancer center EOL care.

Original languageEnglish (US)
JournalJournal of Oncology Practice
Volume8
Issue number4
DOIs
StatePublished - Jul 1 2012
Externally publishedYes

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Terminal Care
Hospices
Benchmarking
Neoplasms
Intensive Care Units
Survival
Psychological Stress
Health Care Costs
Medical Records
Registries
Lung Neoplasms
Hospitalization
Referral and Consultation
Demography
Databases

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)
  • Health Policy

Cite this

Cowall, D. E., Yu, B. W., Heineken, S., Lewis, E. N., Chaudhry, V., & Daugherty, J. M. (2012). End-of-life care at a community cancer center. Journal of Oncology Practice, 8(4). https://doi.org/10.1200/JOP.2011.000451

End-of-life care at a community cancer center. / Cowall, David E.; Yu, Bennett W.; Heineken, Sandra; Lewis, Elizabeth N.; Chaudhry, Vishal; Daugherty, Joan M.

In: Journal of Oncology Practice, Vol. 8, No. 4, 01.07.2012.

Research output: Contribution to journalArticle

Cowall, DE, Yu, BW, Heineken, S, Lewis, EN, Chaudhry, V & Daugherty, JM 2012, 'End-of-life care at a community cancer center', Journal of Oncology Practice, vol. 8, no. 4. https://doi.org/10.1200/JOP.2011.000451
Cowall, David E. ; Yu, Bennett W. ; Heineken, Sandra ; Lewis, Elizabeth N. ; Chaudhry, Vishal ; Daugherty, Joan M. / End-of-life care at a community cancer center. In: Journal of Oncology Practice. 2012 ; Vol. 8, No. 4.
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