A129
Patterns of hospital care near the end of life – an analysis using cancer registry and hospital episodes statistics
Andy Pring, Julia Verne
South West Public Health Observatory, Bristol, UK
Aim
To identify patterns in patient care near the end of life using Hospital Episode Statistics (HES) and Cancer Registry data.
Method
HES data describing inpatient hospital episodes between 1998 and March 2006 was linked with the cancer register in the South West of England (SWPHO). People whose cause of death includes cancer were identified on the cancer register, their HES data extracted and summarised. Later analyses concentrated on cancer of the bladder, breast, colo-rectum, lung, or prostate.
Results
A third of all hospital cancer episodes and half of all cancer bed-days concern people in their final 6 months of life. People who die in hospital from cancer spend nearly twice as long (33 days) in hospital during this time as people who die elsewhere (18 days). On average about 45% of cancer patients die in hospital, but this varies across the SW region from 30% to over 70%. Patients who die from bladder cancer on average receive more inpatient care in their final 6 months (33 days) than patients dying from breast (23), colo-rectum (26), lung (23), or prostate cancer (27).
Conclusion
It is the aim of the NHS End of Life Program to give greater choice for all patients in their place of care and place of death.There is evidence that within the group of people who die of their cancer those who die in hospital are different from those who die elsewhere, this may reflect some people making the choice and/or having the opportunity to make other arrangements.
