Trend analysis of quality indicators in palliative home care among terminally ill cancer and non-cancer patients in Taiwan: a 6-year observational study

Hao-Hsun Chung; Chun-Li Wang; Jia-Jyun Wu; Szu-Pei Chien; Lung-Chun Lee; Ya-Huei Juang; Wei-Min Chu

doi:10.1007/s00520-023-08277-2

Trend analysis of quality indicators in palliative home care among terminally ill cancer and non-cancer patients in Taiwan: a 6-year observational study

Support Care Cancer. 2024 Jan 3;32(1):75. doi: 10.1007/s00520-023-08277-2.

Authors

Hao-Hsun Chung¹, Chun-Li Wang^{2

3

4}, Jia-Jyun Wu^{2

5

4}, Szu-Pei Chien⁶, Lung-Chun Lee², Ya-Huei Juang^#⁷, Wei-Min Chu^#^{8

9

10

11

12}

Affiliations

¹ Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan.
² Department of Family Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan, 40705.
³ Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.
⁴ Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
⁵ Institute of Health Policy and Management, National Taiwan University, Taipei, Taiwan.
⁶ College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁷ Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan. wae5023@yahoo.com.tw.
⁸ Department of Family Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan, 40705. williamchu0110@gmail.com.
⁹ School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. williamchu0110@gmail.com.
¹⁰ Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan. williamchu0110@gmail.com.
¹¹ Geriatrics and Gerontology Research Center, College of Medicine, National Chung Hsing University, Taichung, Taiwan. williamchu0110@gmail.com.
¹² Department of Epidemiology On Aging, National Center for Geriatrics and Gerontology, Aichi, Japan. williamchu0110@gmail.com.

^# Contributed equally.

PMID: 38170324
DOI: 10.1007/s00520-023-08277-2

Abstract

Purpose: Palliative home care services (PHCS) have been emerging for years. However, limited data exist regarding quality indicators for pain control, unplanned hospital readmissions, and household deaths among terminal cancer and non-cancer patients receiving PHCS.

Methods: We conducted a retrospective collection and recording of data from 1242 terminally ill cancer and non-cancer patients receiving PHCS. The data were obtained from the Hospice-Palliative Clinical Database (HPCD) of Taichung Veterans General Hospital (TCVGH) for the period from 2016 to 2021. T test and chi-square test were applied for characteristics and the quality indicators among cancer and non-cancer groups. Chi-square test was used for trend analysis of the number of patients receiving PHCS and the quality indicators among cancer and non-cancer groups throughout the study period.

Results: A total of 1242 terminally ill cancer and non-cancer patients who had received PHCS were documented by TCVGH from the years 2016 to 2021, including 221 non-cancer patients and 1021 cancer patients having an average age of 70. The number of terminally ill cancer and non-cancer patients receiving PHCS has increased annually since 2016. Another finding was that age was a statistically significant factor impacting quality indicators. On the other hand, compared to non-cancer patients, cancer patients had a higher likelihood of receiving treatment with analgesics when needed. Their odds of needing analgesics more than three times within 4 days after PHCS enrollment were significantly elevated [OR 4.188, 95% CI (1.002, 17.51)].

Conclusion: The results of this 6-year observational study indicate a substantial increase in the number of terminal cancer and non-cancer patients receiving PHCS over the past decade. Furthermore, aging plays an important role in life quality of terminal cancer and non-cancer patients.

Keywords: Cancer; Non-cancer; Palliative home care; Quality indicator.

Publication types

Observational Study

MeSH terms

Aged
Analgesics
Home Care Services*
Humans
Neoplasms* / therapy
Palliative Care / methods
Quality Indicators, Health Care
Retrospective Studies
Taiwan
Terminally Ill

Substances

Analgesics