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Article: Integrative Palliative Care Service Model Improved End-of-Life Care and Overall Survival of Advanced Cancer Patients in Hong Kong: A Review of Ten-Year Territory-Wide Cohort

TitleIntegrative Palliative Care Service Model Improved End-of-Life Care and Overall Survival of Advanced Cancer Patients in Hong Kong: A Review of Ten-Year Territory-Wide Cohort
Authors
Keywordscancer
end-of-life care
palliative care
Issue Date2021
PublisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/jpm
Citation
Journal of Palliative Medicine, 2021, v. 24 n. 9, p. 1314-1320 How to Cite?
AbstractBackground: Integrated palliative care in oncology service has been widely implemented in Hong Kong since 2006. Aim: The study aimed to review its impact on end-of-life outcomes and overall survival (OS) of cancer patients, as well as its utilization of health care resources in the past 10 years. Design: Cancer deaths of all 43 public hospitals of Hong Kong were screened. Setting/Participants: Randomly selected 2800 cancer deaths formed a representative cohort in all seven service clusters of Hospital Authority at four time points (2006, 2009, 2012, and 2015). Individual patient records were thoroughly reviewed. Propensity score-matched (PSM) analysis was employed to compare the survival of patients. Results: Palliative care provision was associated with improved palliative care outcome, including more prescription of strong opioid, fewer cardiopulmonary resuscitations and intensive care unit admissions, and less futile chemotherapy usage in the end-of-life period (all p < 0.001). In the PSM analysis, the median OS in patients with palliative service (5.10 months, 95% confidence interval [CI] 4.52–5.68 months) was significantly better than those without palliative service (1.96 months, 95% CI 1.66–2.27 months). Patients in the palliative care group had more specialist clinic visits (p < 0.001) and longer hospital stay (p < 0.001) in the last six months of life, although the duration of last admission stay at acute general ward was shortened (p < 0.001). Conclusion: Our results suggested palliative care has played a role in the remarkable improvement in end-of-life outcomes and OS. However, current palliative care model relied heavily on hospital resources. Future work is needed to strengthen community care and to build up quality monitoring systems.
Persistent Identifierhttp://hdl.handle.net/10722/306374
ISSN
2020 Impact Factor: 2.947
2020 SCImago Journal Rankings: 0.986
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLam, TC-
dc.contributor.authorCHAN, SK-
dc.contributor.authorChoi, CW-
dc.contributor.authorTSANG, KC-
dc.contributor.authorYuen, KK-
dc.contributor.authorSoong, I-
dc.contributor.authorWong, KH-
dc.contributor.authorLui, L-
dc.contributor.authorLo, SH-
dc.contributor.authorTong, M-
dc.contributor.authorLo, RSK-
dc.contributor.authorLam, PT-
dc.contributor.authorLam, WM-
dc.contributor.authorLi, B-
dc.date.accessioned2021-10-20T10:22:42Z-
dc.date.available2021-10-20T10:22:42Z-
dc.date.issued2021-
dc.identifier.citationJournal of Palliative Medicine, 2021, v. 24 n. 9, p. 1314-1320-
dc.identifier.issn1096-6218-
dc.identifier.urihttp://hdl.handle.net/10722/306374-
dc.description.abstractBackground: Integrated palliative care in oncology service has been widely implemented in Hong Kong since 2006. Aim: The study aimed to review its impact on end-of-life outcomes and overall survival (OS) of cancer patients, as well as its utilization of health care resources in the past 10 years. Design: Cancer deaths of all 43 public hospitals of Hong Kong were screened. Setting/Participants: Randomly selected 2800 cancer deaths formed a representative cohort in all seven service clusters of Hospital Authority at four time points (2006, 2009, 2012, and 2015). Individual patient records were thoroughly reviewed. Propensity score-matched (PSM) analysis was employed to compare the survival of patients. Results: Palliative care provision was associated with improved palliative care outcome, including more prescription of strong opioid, fewer cardiopulmonary resuscitations and intensive care unit admissions, and less futile chemotherapy usage in the end-of-life period (all p < 0.001). In the PSM analysis, the median OS in patients with palliative service (5.10 months, 95% confidence interval [CI] 4.52–5.68 months) was significantly better than those without palliative service (1.96 months, 95% CI 1.66–2.27 months). Patients in the palliative care group had more specialist clinic visits (p < 0.001) and longer hospital stay (p < 0.001) in the last six months of life, although the duration of last admission stay at acute general ward was shortened (p < 0.001). Conclusion: Our results suggested palliative care has played a role in the remarkable improvement in end-of-life outcomes and OS. However, current palliative care model relied heavily on hospital resources. Future work is needed to strengthen community care and to build up quality monitoring systems.-
dc.languageeng-
dc.publisherMary Ann Liebert, Inc Publishers. The Journal's web site is located at http://www.liebertpub.com/jpm-
dc.relation.ispartofJournal of Palliative Medicine-
dc.rightsJournal of Palliative Medicine. Copyright © Mary Ann Liebert, Inc Publishers.-
dc.rightsFinal publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org/[insert DOI]-
dc.subjectcancer-
dc.subjectend-of-life care-
dc.subjectpalliative care-
dc.titleIntegrative Palliative Care Service Model Improved End-of-Life Care and Overall Survival of Advanced Cancer Patients in Hong Kong: A Review of Ten-Year Territory-Wide Cohort-
dc.typeArticle-
dc.identifier.emailLam, TC: lamtc03@hku.hk-
dc.identifier.emailChoi, CW: hcchoi@hku.hk-
dc.identifier.authorityLam, TC=rp02128-
dc.identifier.authorityChoi, CW=rp02815-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1089/jpm.2020.0640-
dc.identifier.pmid33507834-
dc.identifier.scopuseid_2-s2.0-85114319073-
dc.identifier.hkuros327856-
dc.identifier.volume24-
dc.identifier.issue9-
dc.identifier.spage1314-
dc.identifier.epage1320-
dc.identifier.isiWOS:000614168300001-
dc.publisher.placeUnited States-

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