Hospital as a site of death of cancer patients in Italy: A registry-based analysis and time trends
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作者:
Numico, Gianmauro
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Azienda Osped S Croce & Carle, Med Oncol, Via M Coppino 26, I-12100 Cuneo, ItalyAzienda Osped S Croce & Carle, Med Oncol, Via M Coppino 26, I-12100 Cuneo, Italy
Numico, Gianmauro
[1
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Ippoliti, Roberto
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Univ East Piedmont, Dept Law & Polit Econ & Social Sci DiGSPES, Alessandria, ItalyAzienda Osped S Croce & Carle, Med Oncol, Via M Coppino 26, I-12100 Cuneo, Italy
Ippoliti, Roberto
[2
]
Antonuzzo, Andrea
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机构:
Fdn IRCCS Ist Nazl Tumori Milano, SSD Cure Supporto Internist & Geriatr, Milan, ItalyAzienda Osped S Croce & Carle, Med Oncol, Via M Coppino 26, I-12100 Cuneo, Italy
Antonuzzo, Andrea
[3
]
Palmero, Lorenza
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机构:
Azienda Osped S Croce & Carle, Med Oncol, Via M Coppino 26, I-12100 Cuneo, ItalyAzienda Osped S Croce & Carle, Med Oncol, Via M Coppino 26, I-12100 Cuneo, Italy
Palmero, Lorenza
[1
]
Bossi, Paolo
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机构:
Humanitas Univ, Dept Biomed Sci, Milan, Italy
IRCCS Humanitas Res Hosp, Milan, ItalyAzienda Osped S Croce & Carle, Med Oncol, Via M Coppino 26, I-12100 Cuneo, Italy
Bossi, Paolo
[4
,5
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机构:
[1] Azienda Osped S Croce & Carle, Med Oncol, Via M Coppino 26, I-12100 Cuneo, Italy
[2] Univ East Piedmont, Dept Law & Polit Econ & Social Sci DiGSPES, Alessandria, Italy
Cancer;
End of life;
Hospital;
Site of death;
PALLIATIVE CARE;
PLACE;
COUNTRIES;
PEOPLE;
END;
D O I:
10.1016/j.canep.2024.102702
中图分类号:
R73 [肿瘤学];
学科分类号:
100214 ;
摘要:
Background: Place of death is relevant both for individuals and for the society. Home is universally considered the optimal place of death while dying in hospital may be a signal of inappropriate end-of-life care. We aimed at studying the place of death of patients with cancer in Italy in a five-year period. Patients and methods: The death-certificate database published by the Italian National Institute of Statistics (ISTAT) was analysed, searching the place of death and the main disease related to death. Data from 2015 to 2019 were used, to exclude the influence of the COVID pandemic. Cancer, "cognitive impairment and Alzheimer's disease" (CIAD) and "cardiovascular and cerebrovascular diseases" (CCD) were the examined diseases. The place of death was categorized as "acute care hospital", "hospice" or "other long-term care (LTC) structures" and "home". We implemented an ordinary linear regression model to verify whether there was a statistically significant variation across the selected time (i), and whether a substitution effect among sites of death could be hypothesized (ii). Results: Data on 769,517 deaths were retrieved. In 2019 35.39 % patients with cancer died in hospital, 39.57 % died at home and 20.06 % died in hospice or in other LTC structures. In the examined period, death at home decreased by 3.09 % (95 % C.I. -3.18 - -2.99; p<0.01); death in hospice and long-term structures increased by 2.71 % (95 % C.I. 2.66 - 2.76; p<0.01); death in hospital increased by 0.3 % (95 % C.I. 0.23 - 0.36; p<0.01). For patients with CIAD, death in hospital increased by 0.98 % (95 % C.I. 0.80 - 1.17; p<001) and for patients with CCD decreased by 1.43 % (95 % I.C. - 1.47 - -1.39; p<0.01). Death at home decreased in both diseases. Conclusions: More than one-third of cancer patients die in acute care hospitals and this percentage is slightly increasing in the analysed period. Mortality at home decreased in all the examined diseases. Dying at home is being progressively less frequent, while hospitals continue to represent a frequent place of death.
机构:
Heidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, GermanyHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany
Luebke, Johannes
Naumann, Nicole
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Heidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, GermanyHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany
Naumann, Nicole
Kreil, Sebastian
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机构:
Heidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, GermanyHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany
Kreil, Sebastian
Metzgeroth, Georgia
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机构:
Heidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, GermanyHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany
Metzgeroth, Georgia
Horny, Hans-Peter
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机构:
Ludwig Maximilians Univ Munchen, Inst Pathol, Munich, GermanyHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany
Horny, Hans-Peter
Sotlar, Karl
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机构:
Med Univ Salzburg, Inst Pathol, Salzburg, AustriaHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany
Sotlar, Karl
Cross, Nicholas C. P.
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机构:
Univ Southampton, Fac Med, Southampton, Hants, EnglandHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany
Cross, Nicholas C. P.
Fabarius, Alice
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机构:
Heidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, GermanyHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany
Fabarius, Alice
Valent, Peter
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机构:
Ludwig Boltzmann Inst Hematol & Oncol, Vienna, Austria
Med Univ Vienna, Dept Internal Med 1, Div Hematol & Hemostaseol, Vienna, AustriaHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany
Valent, Peter
Hofmann, Wolf-Karsten
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机构:
Heidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, GermanyHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany
Hofmann, Wolf-Karsten
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Schwaab, Juliana
Reiter, Andreas
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机构:
Univ Med Ctr Mannheim, Mannheim, GermanyHeidelberg Univ, Med Fac Mannheim, Dept Hematol & Oncol, Mannheim, Germany