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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.
- Source :
-
Journal of the American Medical Directors Association . Jun2020, Vol. 21 Issue 6, p858-858. 1p. - Publication Year :
- 2020
-
Abstract
- 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. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BLOOD transfusion
*CARDIOPULMONARY resuscitation
*DEMENTIA patients
*DIET therapy
*HEMODIALYSIS
*HOSPICE care
*HOSPITAL care
*HOSPITAL emergency services
*INTENSIVE care units
*LIFE support systems in critical care
*LONGITUDINAL method
*MEDICAL appointments
*MEDICAL care use
*HEALTH policy
*PALLIATIVE treatment
*SENILE dementia
*TERMINAL care
*VENTILATION
*RETROSPECTIVE studies
*FEEDING tubes
*OLD age
Subjects
Details
- Language :
- English
- ISSN :
- 15258610
- Volume :
- 21
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Journal of the American Medical Directors Association
- Publication Type :
- Academic Journal
- Accession number :
- 143744480
- Full Text :
- https://doi.org/10.1016/j.jamda.2020.04.011