Indexed on: 15 Mar '18Published on: 15 Mar '18Published in: Wiener Medizinische Wochenschrift
The topic of "medical oversupply at the end-of-life" is being discussed intensively internationally. The aim of this paper is to present the data of end-of-life care in one region in Austria (Lower Austria). The data basis for the end-of-life indicators was the routine data (secondary data analysis) of the Lower Austrian District Health Insurance Fund (NÖGKK) from 2015. The basic population consisted of persons with inpatient hospitalization with a cancer diagnosis. Primary endpoints included place of death and time of death, hospital admission, and special end-of-life therapies (30 days before death). NÖGKK insured persons older than 16 years and a subpopulation older than 65 years were evaluated. 2788 cancer patients (NÖGKK insured) were included. 61.1% died in a hospital, 17.9% of them on the day of admission. In 16.2% of all patients, death occurred on a palliative care unit, 9.3% died in an intensive care unit. The hospitalization rate 30 days before death was 61.6%. Hospital admission was more common in men than in women. 9.4% of total deaths received chemotherapy, radiotherapy, or monoclonal antibodies within the last 30 days. In international comparison, the region of Lower Austria shows very high hospital admission and hospital mortality rates. Further investigations for the entire country (all regions) are therefore desirable. The establishment of a discussion about the medical oversupply at the end-of-life in Austria, including appropriate care concepts and care models, is needed.