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Abstract

Background: International studies show that most people prefer to die at home. This study aims to investigate the patterns in Place of Death (PoD) for cancer patients at the State of Qatar. Method: Retrospective, population-based study analyzing all registered cancer deaths in Qatar between January 1, 2006 and December 31, 2012 (n=1,224). Patient characteristics: Age, gender, nationality, cancer diagnosis, year of death, and PoD were analyzed. Time trends for age-standardized proportions of death in individual PoDs were evaluated using chi-square analysis. Odds ratio (OR) were determined for variables associated with the most preferred (acute palliative care unit [APCU] and hematology/oncology ward) versus least preferred (ICU and general medicine ward) PoDs in Qatar, stratified by nationality. Results: The hematology/oncology ward was the most common PoD (32.4%) followed by ICU (31.4%), APCU (26.9%), and general medicine ward (9.2%). APCU trended upward (+0.057/year; p<0.001), while the hematology/oncology ward trended downward (20.055/year; p<0.001). No statistically significant changes occurred in the other PoDs; home deaths remained low (0.4%). Qataris who died from liver cancer (OR 0.23) and aged 65 or older (OR 0.64) were less likely to die in the APCU or hematology/oncology ward (p<0.05). Non-Qataris who died from pancreatic cancer (OR 3.12) and female (OR 2.05) were more likely to die in the APCU or hematology/oncology ward (p<0.05). Both Qataris and non- Qataris who died from hematologic malignancy (OR 0.18 and 0.41, respectively) were more likely to die in the ICU or general medicine ward (p<0.05). Conclusion: A high percentage of cancer deaths in Qatar occur in hospital. As home was the preferred PoD for most people, effective home care and hospice programs are needed to improve end-of-life cancer care.

Biography

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