The trend of aggressive treatments in end-of-life care for older people with dementia after a policy change in Taiwan

YH Hsu, MY Chou, HM Chen, WC Chang… - Journal of the American …, 2020 - Elsevier
YH Hsu, MY Chou, HM Chen, WC Chang, CS Chu, YC Wang, CL Hsu, CK Liang, CC Lee
Journal of the American Medical Directors Association, 2020Elsevier
Objectives We evaluated the trend of end-of-life healthcare utilization and life-sustaining
interventions for older adults with dementia 3 to 4 years after the change in hospice policy.
Design Population-based retrospective cohort study. Setting and participants We used the
National Health Insurance Research database of enrolled patients≥ 65 years of age
diagnosed with dementia who died in 2010-2013 (n= 2062). Methods Aggressive
treatments, including healthcare utilization and life-sustaining interventions, were recorded …
Objectives
We evaluated the trend of end-of-life healthcare utilization and life-sustaining interventions for older adults with dementia 3 to 4 years after the change in hospice policy.
Design
Population-based retrospective cohort study.
Setting and participants
We used the National Health Insurance Research database of enrolled patients ≥65 years of age diagnosed with dementia who died in 2010-2013 (n = 2062).
Methods
Aggressive treatments, including healthcare utilization and life-sustaining interventions, were recorded within 6 months of death. Aggressive healthcare utilization included ≥1 emergency department visits, ≥1 hospitalizations, >14 days of hospitalization, intensive care unit admission, and death in an acute care hospital. Life-sustaining interventions were enteral tube, artificial nutrition, blood transfusion, hemodialysis, invasive ventilation, and cardiopulmonary resuscitation.
Results
Compared with 2010‒2012, 2013 rates significantly decreased for all measures (P < .001). Composite scores of healthcare utilization and life-sustaining treatments in 2013 were significantly lower than for 2010‒2012, after controlling for confounding variables (both P < .001).
Conclusions and implications
Older patients with dementia had a trend of reduced healthcare utilization and fewer life-sustaining treatments near the end of life from 2010 to 2013 after a policy change.
Elsevier
以上显示的是最相近的搜索结果。 查看全部搜索结果