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Meeting ReportMechanical Ventilation

Hospice Palliative Care Affects Medical Utilization in Prolonged Mechanical Ventilation

Chin-Jung Liu, Yeong-Ruey Chu, Chia-Chen Chu and Wen-Chen Tsai
Respiratory Care October 2021, 66 (Suppl 10) 3608970;
Chin-Jung Liu
Respiratory Therapy, China Medical University Hospital, Taichung, Taiwan
School of Nursing & Graduate Institute of Nursing, China Medical University, Taichung, Taiwan
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Yeong-Ruey Chu
Department of Public Health, China Medical University, Taichung, Taiwan
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Chia-Chen Chu
Respiratory Therapy, China Medical University Hospital, Taichung, Taiwan
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Wen-Chen Tsai
Department of Health Services Administration, China Medical University, Taichung, Taiwan
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Abstract

Background: A number of studies have shown that hospice palliative care intervention in the cancer patients can reduce medical utilization. In Taiwan we have 20-25% prolonged mechanical ventilation population, only little research discussing the effectiveness of hospice palliative care in patients who prolonged mechanical ventilation. The purpose of this study was to explore the interest of patients undergoing PMV in hospice palliative care as the effectiveness on medical utilization.

Methods: This was a population-based retrospective matched cohort study. This study used the Taiwan Health Insurance whole population database to analyze data of patients undergoing PMV whose ages were ≥ 18 y from 2009 to 2017. Our aim was to analyze the rate at which patients undergoing PMV elected to join the hospice Palliative Care Program of the National Health Insurance and the impact of the program on related factors. The control group was obtained by 1:1 matching using propensity scoring after excluding patients who participated in palliative care > 181 d or < 15 d. We also sought to compare utilization of intensive care and emergency care before 14 days of death between those who accepted hospice palliative care and those who did not. Furthermore, we used conditional logistic regression analysis to explore ICU readmission, emergency department presentation, and cardiopulmonary resuscitation incidence.

Results: The number of prolonged mechanical ventilation of the emergency visits (odds ratio [OR] = 0.68, 95% CI: 0.63–0.74), ICU hospitalization (OR = 0.59, 95% CI: 0.53–0.46), and cardiopulmonary resuscitation (OR = 0.40, 95% CI: 0.35–0.46) was lower in the palliative care group.

Conclusions: Patients undergoing PMV participating in hospice palliative care can significantly reduce ICU admittance, cardiopulmonary resuscitation utilization, and medical expenses at ≤14 d before death.

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Respiratory Care
Vol. 66, Issue Suppl 10
1 Oct 2021
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Hospice Palliative Care Affects Medical Utilization in Prolonged Mechanical Ventilation
Chin-Jung Liu, Yeong-Ruey Chu, Chia-Chen Chu, Wen-Chen Tsai
Respiratory Care Oct 2021, 66 (Suppl 10) 3608970;

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Hospice Palliative Care Affects Medical Utilization in Prolonged Mechanical Ventilation
Chin-Jung Liu, Yeong-Ruey Chu, Chia-Chen Chu, Wen-Chen Tsai
Respiratory Care Oct 2021, 66 (Suppl 10) 3608970;
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