ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2018
The challenge of sustainability in healthcare systems: frequency and cost of diagnostic procedures in end-of-life cancer patients.
Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Incidence of Catastrophic Health Expenditure and Its Determinants in Cancer Patients: A Systematic Review and Meta-analysis.Applied health economics and health policy · 2021Pooled it
- End‑of‑life care in advanced melanoma: a retrospective cohort study from an Italian comprehensive cancer center.BMC cancer · 2026Article
- Identifying independent risk factors of mortality among patients receiving a leadless pacemaker: A longitudinal retrospective study in a single center.Heart rhythm O2 · 2026Article
- Review
- Financial cost of end-of-life cancer care in palliative care units (PCUs) and non-PCUs in Iran: insights from low- and middle-income countries.Palliative care and social practice · 2024Article
- Palliative care and imaging utilisation for patients with cancer.BMJ supportive & palliative care · 2022Observational
- Handheld Ultrasound (HHUS): Potential for Home Palliative Care.Ultrasound international open · 2022Review
- The effect of a palliative care pathway on medical interventions at the end of life: a pre-post-implementation study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
- How aging of the global population is changing oncology.Ecancermedicalscience · 2021Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLiterature data on the overuse and misuse of diagnostic procedures leading to end-of-life aggressiveness are scarce due to the limited amount of estimated economic waste. This study investigated the potential overuse of diagnostic procedures in a population of end-of-life patients.
methodsThis is a retrospective study on consecutive advanced patients admitted into two Italian hospices. Frequency and relative costs of X-ray imaging, CT scans, MRI, and interventional procedures prescribed in the 3 months before admission were collected in patient electronic charts and/or in administrative databases. We conducted a deeper analysis of 83 cancer patients with a diagnosis of at least 1 year before admission to compare the number of examinations performed at two distant time periods.
resultsOut of 541 patients, 463 (85.6%) had at least one radiological exam in the 3 months before last admission. The mean radiological exam number was 3.9 ± 3.2 with a relative mean cost of 278.60 ± 270.20 € per patient with a statistically significant (p < 0.001) rise near death. In the 86-patient group, a higher number of procedures was performed in the last 3 months of life than in the first quarter of the year preceding last admission (38.43 ± 28.62 vs. 27.95 ± 23.21, p < 0.001) with a consequent increase in cost.
conclusionsPatients nearing death are subjected to a high level of "diagnostic aggressiveness." Further studies on the integration of palliative care into the healthcare pathway could impact the appropriateness of interventions, quality of care, and, ultimately, estimated costs.
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