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Burden of Healthcare Utilization among Chronic Obstructive Pulmonary Disease Patients with and without Cancer Receiving Palliative Care: A Population-Based Study in Taiwan

Author

Listed:
  • Li-Ting Kao

    (Department of Respiratory Therapy, Chi Mei Medical Center, Tainan 71004, Taiwan)

  • Kuo-Chen Cheng

    (Department of Internal Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan
    Department of Safety Health and Environment, Chung Hwa University of Medical Technology, 71703 Tainan, Taiwan)

  • Chin-Ming Chen

    (Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan)

  • Shian-Chin Ko

    (Palliative Care Center, Chi-Mei Medical Center, Tainan 71004, Taiwan)

  • Ping-Jen Chen

    (Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London W1T 7NF, UK
    Department of Family Medicine and Division of Geriatrics and Gerontology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80756, Taiwan
    School of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan)

  • Kuang-Ming Liao

    (Department of Internal Medicine, Chi Mei Medical Center, Chiali, Tainan 72263, Taiwan)

  • Chung-Han Ho

    (Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan
    Department of Hospital and Health Care Management, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan)

Abstract

Chronic obstructive pulmonary disease (COPD) is a chronic disease that burdens patients worldwide. This study aims to discover the burdens of health services among COPD patients who received palliative care (PC). Study subjects were identified as COPD patients with ICU and PC records between 2009 and 2013 in Taiwan’s National Health Insurance Research Database. The burdens of healthcare utilization were analyzed using logistic regression to estimate the difference between those with and without cancer. Of all 1215 COPD patients receiving PC, patients without cancer were older and had more comorbidities, higher rates of ICU admissions, and longer ICU stays than those with cancer. COPD patients with cancer received significantly more blood transfusions (Odds Ratio, OR: 1.66; 95% C.I.: 1.11–2.49) and computed tomography scans (OR: 1.88; 95% C.I.: 1.10–3.22) compared with those without cancer. Bronchoscopic interventions (OR: 0.26; 95% C.I.: 0.07–0.97) and inpatient physical restraints (OR: 0.24; 95% C.I.: 0.08–0.72) were significantly more utilized in patients without cancer. COPD patients without cancer appeared to receive more invasive healthcare interventions than those without cancer. The unmet needs and preferences of patients in the life-limiting stage should be taken into consideration for the quality of care in the ICU environment.

Suggested Citation

  • Li-Ting Kao & Kuo-Chen Cheng & Chin-Ming Chen & Shian-Chin Ko & Ping-Jen Chen & Kuang-Ming Liao & Chung-Han Ho, 2020. "Burden of Healthcare Utilization among Chronic Obstructive Pulmonary Disease Patients with and without Cancer Receiving Palliative Care: A Population-Based Study in Taiwan," IJERPH, MDPI, vol. 17(14), pages 1-12, July.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:14:p:4980-:d:382962
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    Cited by:

    1. Hui-Mei Lin & Yen-Chun Huang & Chieh-Wen Ho & Mingchih Chen, 2022. "Analysis of Palliative Care Utilization and Medical Expenses among Patients with Chronic Diseases in Taiwan: A Population-Based Cohort Study," IJERPH, MDPI, vol. 19(19), pages 1-12, October.
    2. Doris Y. P. Leung & Helen Y. L. Chan, 2020. "Palliative and End-of-Life Care: More Work is Required," IJERPH, MDPI, vol. 17(20), pages 1-7, October.

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