Variations in End-Of-Life Care among Cancer Affected Seniors Essay

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Details : summarizing the different sections of the journal: abstract, Introduction, methods, results; discussion; (title and reference pages should be counted as additional pages); you should also include a personal discussion paragraph where you state how you feel about the topic.

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The purpose of this research is to measure the intensity of end-of-life (EOL) for Medicare cancer patients and variations in care by age, gender, and race. The research methods entailed a retrospective cohort analysis of Medicare claims examined 235,821 Medicare parts A and B patients dying from poor prognosis cancers from 2003 to 2007. Regression models quantified the relationships between care intensity and age, gender, and race. The measures involved included emergency department (ED) visits, hospitalizations, and Intensive care UnitS (ICU) admissions, late-life chemotherapy, in-hospital deaths, , and overall and late hospice enrollment within six months of death. The research found that within 30 days of death, 61.3% of the patients would be hospitalized, 10.2% would br hospitalized more than once , 10.2% would visit an ED more than once, 28.8% died in hospital, and 23.7% had ICU admissions. In the final six months, 55.2% accessed a hospice, 15.1% within three days of death. Older age would be associated with lower odd ratios (ORs) for aggressive care, and OR of 0.92 for late hospice enrollment. Female gender would be associated with lower ORs for aggressive care, and an OR 0.84 for late hospice enrollment. Black race would be linked to higher OR for aggressive care, and a lower OR for late chemotherapy, and late hospice enrollment. The research concluded that seniors dying with poor prognosis cancer also experienced high-intensity care with rates differing with age, gender, and race.



High quality EOL cancer highlights on palliation for effective control of symptoms and supportive services. Although institutions acknowledge the value of limiting aggressive cancer therapy with an aim of prolonging life and putting in place palliative care, patients are often faced with the burden with some treatments misaligned with their preferences. Using a range of methods, Earle and his colleagues devised three domains of aggressive EOL cancer care observed in administrative data: that is possible misuse of acute care; overusing chemotherapy; and late or no access to hospice services. Benchmarks would be derived by assessing the performance of all providers by healthcare service areas as a realistic standard. In this paper Miesfeldt et al Earl and colleagues’ benchmarks to analyze the quality gaps in EOL care among seniors, and examined variations by age, gender, and race.

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