Original Article Impact of age on end-of-life care for adult Taiwanese cancer decedents, 2001–2006

Background: With increasing patient age in Western countries, evidence indicates a pervasive pattern of decreasing healthcare expenditures and less aggressive medical care, including end-of-life (EOL) care. However, the impact of age on EOL care for Asian cancer patients has not been investigated. Purpose: To explore how healthcare use at EOL varies by age among adult Taiwanese cancer patients. Methods: Retrospective cohort study using administrative data among 203,743 Taiwanese cancer decedents, 2001–2006. Age was categorized as 18–64, 65–74, 75–84, and 85 years. Results: Elderly (65 years) Taiwanese cancer patients were significantly less likely than those 18–64 years to receive aggressive treatment in their last month of life, including chemotherapy,>1 emergency room visits,>1 hospital admis-sions,>14 days of hospitalization, hospital death, intensive care unit admission, cardiopulmonary resuscitation, intuba-tion, and mechanical ventilation. However, they were significantly more likely to receive hospice care in their last year of life. Conclusion: Elderly Taiwanese cancer patients at EOL received less chemotherapy, less aggressive management of health crises associated with the dying process, and fewer life-extending treatments, but they were more likely to receive hospice care in their last year and to achieve the culturally highly valued goal of dying at home