Trends in palliative care utilization among older adult decedents with and without cancer in Taiwan: a population-based comparative study

IF 7.6 1区医学 Q1 HEALTH CARE SCIENCES & SERVICES

The Lancet Regional Health: Western Pacific Pub Date : 2025-02-01 DOI:10.1016/j.lanwpc.2025.101479

Yu-Tai Lo , Tzu-Jung Chuang , Yu-Tung Huang , Yi-Lin Wu , Yi-Ching Yang , Chung-Yi Li

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引用次数: 0

Abstract

Background

The leading causes of death among the older adults have shifted from cancer to non-cancer conditions such as ischemia heart diseases, stroke, and dementia, affecting end-of-life care needs. This study examined the difference in the proportion of palliative care utilization in relation to specific causes of death and compared the trends in palliative care utilization between older adult decedents with and without cancer in Taiwan from 2010 to 2020.

Methods

The study utilized data from the Health and Welfare Data Science Center in Taiwan, covering demographic and healthcare variables for 588,010 decedents aged 65+ years who died between 2010 and 2020. We used Poisson regression to investigate the temporal trends in palliative care utilization during the last six months of life. Multivariable logistic regression models were constructed to analyze cancer, and non-cancer causes of death associated with palliative care utilization.

Findings

The proportion of palliative utilization in cancer deaths started at 21.7% in 2010 and increased to 63.2% by 2020 with the beta coefficient of 0.09 (95% CI: 0.09–0.09). The proportion of palliative utilization in non-cancer deaths started at 0.8% in 2010 and increased to 23.5% by 2020, with the beta coefficient of 0.26 (95% CI: 0.26–0.26). Compared to deceased cancer patients, deceased non-cancer individuals were less likely to have received palliative care (OR = 0.12, 95% CI: 0.12–0.13).

Interpretation

Efforts to ensure equitable access to palliative care for non-cancer individuals should focus on expanding services, enhancing provider education, and promoting cultural sensitivity to meet the growing need for palliative care integration.

Funding

This study was supported in part by grants from the National Cheng Kung University Hospital (NCKUH-11305001, NCKUH-V101-10) and the National Health Research Institutes (NHRI-13A1-CG-CO-04-2225-1). The sponsors had no influence on the study.

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来源期刊

The Lancet Regional Health: Western Pacific Medicine-Pediatrics, Perinatology and Child Health

CiteScore

8.80

自引率

2.80%

发文量

305

审稿时长

11 weeks

期刊介绍： The Lancet Regional Health – Western Pacific, a gold open access journal, is an integral part of The Lancet's global initiative advocating for healthcare quality and access worldwide. It aims to advance clinical practice and health policy in the Western Pacific region, contributing to enhanced health outcomes. The journal publishes high-quality original research shedding light on clinical practice and health policy in the region. It also includes reviews, commentaries, and opinion pieces covering diverse regional health topics, such as infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, aging health, mental health, the health workforce and systems, and health policy.