The Trend of Aggressive Treatments in End-of-Life Care for Older People With Dementia After a Policy Change in Taiwan
In: Journal of the American Medical Directors Association, Jg. 21 (2019-06-18), Heft 6
Online
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Zugriff:
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.Population-based retrospective cohort study.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).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.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).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.
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The Trend of Aggressive Treatments in End-of-Life Care for Older People With Dementia After a Policy Change in Taiwan
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Autor/in / Beteiligte Person: | Ying Hsin Hsu ; Lee, Ching-Chih ; Chu, Che-Sheng ; Chang, Wei-Cheng ; Chen, Hsiu-Min ; Ming Yueh Chou ; Yu Chun Wang ; Hsu, Chiao-Lin ; Chih Kuang Liang ; Yu Te Lin |
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Zeitschrift: | Journal of the American Medical Directors Association, Jg. 21 (2019-06-18), Heft 6 |
Veröffentlichung: | 2019 |
Medientyp: | unknown |
ISSN: | 1538-9375 (print) |
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