Variation in the use of palliative radiotherapy at end of life: Examining demographic, clinical, health service, and geographic factors in a population-based study

Palliative Medicine - Tập 25 Số 2 - Trang 101-110 - 2011
M. Ruth Lavergne1, Grace Johnston2, Jun Gao3, Trevor Dummer4, D. Rheaume5
1Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
2School of Health Administration, Dalhousie University, Halifax and Surveillance and Epidemiology Unit, Cancer Care Nova Scotia, Halifax, Canada
3Health Canada, Ottawa, Canada
4Population Cancer Research Program, Dalhousie University, Halifax, Canada
5Department of Radiation Oncology, Dalhousie University, Halifax, Canada

Tóm tắt

Palliative radiotherapy (PRT) can improve quality of life for people dying of cancer. Variation in the delivery of PRT by factors unrelated to need may indicate that not all patients who may benefit from PRT receive it. In this study, 13,494 adults who died of cancer between 2000 and 2005 in Nova Scotia, Canada, were linked to radiotherapy records. Multivariate logistic regression was used to examine the relationships among demographic, clinical, service, and geographic variables, and PRT consultation and treatment. Among the decedents, 4188 (31.0%) received PRT consultation and 3032 (22.3%) treatment. PRT declined with increased travel time and community deprivation. Females, older persons, and nursing home residents also had lower PRT rates. Variations were observed by cancer site and previous oncology care. Variations in PRT use should be discussed with referring physicians, and improved means of access to PRT considered. Benchmarks for optimal rates of PRT are needed.

Từ khóa


Tài liệu tham khảo

10.1177/104990910201900307

10.1177/082585979501100104

Nielsen OS, 2002, Eur J Cancer, 37, S279, 10.1016/S0959-8049(01)80032-0

10.1016/S0147-0272(97)80004-9

10.1016/j.ijrobp.2004.05.053

10.1046/j.1440-1673.2003.01175.x

Samant RS, 2002, Curr Oncol, 9, 20

10.1016/S0360-3016(00)00713-6

10.1200/JCO.2002.20.6.1584

10.1200/JCO.2001.19.1.137

10.1200/JCO.2001.19.14.3323

10.1016/j.clon.2008.04.013

10.1097/PPO.0b013e31804675d4

10.1200/JCO.2004.11.151

10.1080/02841860600979005

10.1016/S0167-8140(02)00366-3

Statistics Canada. 2006 Community profiles, 3/07 update. http://www.statcan.ca/bsolc/english/bsolc?catno=92-591-XWE.

10.1080/136588100240976

10.1016/S0277-9536(03)00071-6

Morris R, 1991, J Publ Health Med, 13, 318

Townsend P, 1988, Health and deprivation: Inequality and the north

10.1016/j.socscimed.2007.10.008

10.1111/j.1541-0064.2007.00191.x

Pampalon R, 2000, Chronic Dis Can, 21, 104

du Plessis V, 2001, Rural small town anal bull, 3

10.1007/s00520-007-0218-y

10.1007/978-1-4419-6824-1

10.1093/ageing/afl001

10.1097/MLR.0b013e31817d931d

10.1179/096992610x12624290276665

10.1016/j.ijrobp.2007.04.059

10.1191/0269216302pm550xx

10.1191/0269216303pm774oa

10.1191/0269216306pm1146oa

Burge F, 2003, CMAJ, 168, 265

10.1016/j.radonc.2005.11.008

10.1200/JCO.2006.09.5281

10.1016/S0936-6555(03)00113-4

10.1016/S0167-8140(99)00097-3

10.1016/j.clon.2008.01.002

Thông tin
Thông tin xuất bản

Palliative Medicine

Tập 25 Số 2

101-110

Thông tin tác giả