Reduction in potentially inappropriate end-of-life hospital care for cancer patients during the COVID-19 pandemic: A retrospective population-based study

Ellis Slotman*, Heidi P. Fransen, Hanneke W.M. van Laarhoven, Marieke H.J. van den Beuken-van Everdingen, Vivianne C.G. Tjan-Heijnen, Auke M.T. Huijben, Agnes Jager, Lia van Zuylen, Evelien J.M. Kuip, Yvette M. van der Linden, Natasja J.H. Raijmakers, Sabine Siesling

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

6 Downloads (Pure)

Abstract

Background: The COVID-19 pandemic impacted cancer diagnosis and treatment. However, little is known about end-of-life cancer care during the pandemic. Aim: To investigate potentially inappropriate end-of-life hospital care for cancer patients before and during the COVID-19 pandemic. Design: Retrospective population-based cohort study using data from the Netherlands Cancer Registry and the Dutch National Hospital Care Registration. Potentially inappropriate care in the last month of life (chemotherapy administration, >1 emergency room contact, >1 hospitalization, hospitalization >14 days, intensive care unit admission or hospital death) was compared between four COVID-19 periods and corresponding periods in 2018/2019. Participants: A total of 112,919 cancer patients (⩾18 years) who died between January 2018 and May 2021 were included. Results: Fewer patients received potentially inappropriate end-of-life care during the COVID-19 pandemic compared to previous years, especially during the first COVID-19 peak (22.4% vs 26.0%). Regression analysis showed lower odds of potentially inappropriate end-of-life care during all COVID-19 periods (between OR 0.81; 95% CI 0.74–0.88 and OR 0.92; 95% CI 0.87–0.97) after adjustment for age, sex and cancer type. For the individual indicators, fewer patients experienced multiple or long hospitalizations, intensive care unit admission or hospital death during the pandemic. Conclusions: Cancer patients received less potentially inappropriate end-of-life care during the COVID-19 pandemic. Because several factors may have contributed, it is unclear whether this reflects better quality care. However, these findings raise important questions about what pandemic-induced changes in care practices can help provide appropriate end-of-life care for future patients in the context of increasing patient numbers and limited resources.

Original languageEnglish
Pages (from-to)140-149
Number of pages10
JournalPalliative Medicine
Volume38
Issue number1
Early online date23 Dec 2023
DOIs
Publication statusPublished - Jan 2024

Keywords

  • cohort studies
  • COVID-19
  • neoplasms
  • palliative care
  • terminal care
  • UT-Hybrid-D

Fingerprint

Dive into the research topics of 'Reduction in potentially inappropriate end-of-life hospital care for cancer patients during the COVID-19 pandemic: A retrospective population-based study'. Together they form a unique fingerprint.

Cite this