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Leuk Lymphoma. 2019 Feb 7:1-9. doi: 10.1080/10428194.2018.1564047. [Epub ahead of print]

Patterns of end-of-life hospital care for patients with non-Hodgkin lymphoma: exploring the landscape.

Author information

1
a Department of Medicine , University of Melbourne , Melbourne , Australia.
2
b St Vincent's Hospital , Melbourne , Australia.
3
c Palliative Care Service, Royal Melbourne Hospital & Peter MacCallum Cancer Centre , Melbourne , Australia.
4
d Department of Clinical Haematology , Royal Melbourne Hospital , Melbourne , Australia.
5
e Department of Radiation Oncology , Alfred Health , Melbourne , Australia.
6
f Department of Medical Oncology , St Vincent's Hospital Melbourne , Melbourne , Australia.
7
g Department of Nursing , University of Melbourne , Melbourne , Australia.
8
h Centre for Palliative Care , St Vincent's Hospital & University of Melbourne & Vrije University , Brussels , Belgium.
9
i Department of Public Health , La Trobe University , Australia.

Abstract

Rapid change, treatment responsiveness, and prognostication difficulties present challenges for palliative care integration for hematology patients. This Australian study aimed to document end-of-life hospital care for patients with non-Hodgkin lymphoma (NHL) to consider opportunities for palliative care integration. A retrospective population cohort design examining existing linked datasets of health service utilization and death registration. The results revealed 4380 NHL patients, majority male (58%) and aged 70+ years (70%), spent 32 days (median) in hospital in final 6 months of life, and in the last month, 56% had more than 1 hospital admission, and 57% stayed more than 14 days. Forty-one percent accessed palliative care, with first contact 23 days (median) before death, and for 77% in final admission. Early palliative care was more likely for patients with greater symptom burden. This study mapping patterns of care for patients who die from NHL establishes a baseline enabling comparisons for future care innovations.

KEYWORDS:

Palliative care; health service utilization; non-Hodgkin lymphoma

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