Home Care Use and Out-of-Hospital Death in Pancreatic Cancer Patients: A Retrospective Cohort Study.

IF 1.3 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES
Journal of Palliative Care Pub Date : 2023-04-01 Epub Date: 2022-02-18 DOI:10.1177/08258597221075088
Mehdi Hegagi, Paul James, Amy Hsu, Peter Tanuseputro
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引用次数: 1

Abstract

Objective: This study aimed to determine the factors associated with usage of home care, including palliative home care, in patients with pancreatic cancer in Ontario. In addition, this study attempted to investigate factors associated with early-onset palliative home care as well as the impact of home care services on survival and out-of-hospital death. Methods: The Ontario Cancer Registry (OCR) was used to identify and capture basic patient/cancer characteristics of index cases of pancreatic cancer diagnosed between April first, 2010 and March 31st, 2016. Patients that received home care were identified using the Home Care Database (HCD) and stratified into general, transition-to-palliative, and early-onset palliative home care. Logistic regressions were used to describe determinants of home care use and determinants of out-of-hospital death. Results: A total of 6888 pancreatic cancer patients met eligibility criteria for this study. A high proportion of patients (83.7%) received home care, including palliative home care (56.8%). In general, older patients (OR = 3.07) and those with more advanced malignancy (OR = 4.98) for stage 4 versus stage 1) had greater odds of receiving palliative home care. Patients receiving home care (P < .01) and those residing in rural regions (P < .01) had greater odds of out-of-hospital death. Conclusion: A large proportion of patients with pancreatic cancer are directed to home care and those that do are more likely to die outside of hospital. Age and stage at diagnosis are significant predictors of home care use. Differences exist in the healthcare experience of patients depending on if they receive home care services and the type of home care.

胰腺癌患者使用家庭护理与院外死亡:回顾性队列研究
研究目的本研究旨在确定安大略省胰腺癌患者使用家庭护理(包括姑息性家庭护理)的相关因素。此外,本研究还试图调查与早期姑息性家庭护理相关的因素,以及家庭护理服务对生存和院外死亡的影响。研究方法利用安大略省癌症登记处(OCR)对2010年4月1日至2016年3月31日期间确诊的胰腺癌指数病例进行识别并获取患者/癌症基本特征。通过家庭护理数据库(HCD)确定了接受家庭护理的患者,并将其分为普通型、向姑息治疗过渡型和早期姑息治疗型家庭护理。使用逻辑回归描述了使用家庭护理的决定因素和院外死亡的决定因素。结果:共有 6888 名胰腺癌患者符合本研究的资格标准。大部分患者(83.7%)接受了家庭护理,包括姑息性家庭护理(56.8%)。一般来说,年龄较大的患者(OR = 3.07)和恶性程度较高的晚期患者(OR = 4.98)(4 期与 1 期相比)接受家庭姑息护理的几率更大。接受家庭护理的患者(P P 结论:很大一部分胰腺癌患者会接受家庭护理,而接受家庭护理的患者更有可能在医院外死亡。诊断时的年龄和分期是使用家庭护理的重要预测因素。根据患者是否接受家庭护理服务和家庭护理类型的不同,他们的医疗体验也存在差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Palliative Care
Journal of Palliative Care 医学-卫生保健
CiteScore
3.20
自引率
5.90%
发文量
63
审稿时长
>12 weeks
期刊介绍: The Journal of Palliative Care is a quarterly, peer-reviewed, international and interdisciplinary forum for practical, critical thought on palliative care and palliative medicine. JPC publishes high-quality original research, opinion papers/commentaries, narrative and humanities works, case reports/case series, and reports on international activities and comparative palliative care.
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