ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2018
Rural versus urban differences in end-of-life care for lung cancer patients in Germany.
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 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- End-of-Life Cancer Care Resource Utilisation in Rural Versus Urban Settings: A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Exploring routine palliative care delivery to inform tailored digitalization approaches - a qualitative interview study.BMC palliative care · 2026Article
- The role of general practitioners in German cancer care: a scoping review.BMC primary care · 2026Article
- Palliative care in rural, remote, and northern communities: a scoping review.BMC palliative care · 2026Article
- Scoping review of anticancer drug utilization in lung cancer patients at the end of life.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Article
- Frequency of anticancer drug use at the end of life: a scoping review.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024Article
- What health inequalities exist in access to, outcomes from and experience of treatment for lung cancer? A scoping review.BMJ open · 2023Article
- Does Geography Play a Role in the Receipt of End-of-Life Care for Advanced Cancer Patients? Evidence from an Australian Local Health District Population-Based Study.Journal of palliative medicine · 2023Article
- Use of algorithms for identifying patients in a German claims database: learnings from a lung cancer case.BMC health services research · 2022Observational
- Effectiveness of two types of palliative home care in cancer and non-cancer patients: A retrospective population-based study using claims data.Palliative medicine · 2021Article
- Comparing two models of outpatient specialised palliative care.BMC palliative care · 2021Article
- Access to Palliative Care for Cancer Patients Living in a Northern and Rural Environment in Ontario, Canada: The Effects of Geographic Region and Rurality on End-of-Life Care in a Population-Based Decedent Cancer Cohort.Clinical Medicine Insights. Oncology · 2019Article
- "Age matters"-German claims data indicate disparities in lung cancer care between elderly and young patients.PloS one · 2019Article
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess rural-urban differences in healthcare utilization and supportive care at the end-of-life in German lung cancer patients.
methodsWe identified 12,929 patients with incident lung cancer in 2009 from claims data and categorized them to four district types (major city, urban, rural, remote rural). We compared site of death, unplanned hospitalizations, hospital days, outpatient doctor, general practitioner (GP) and home visits, structured palliative care, therapy with antidepressants, pain relief medication and chemotherapy, and therapeutic puncturing in the last 30 and 14 days of life using mixed models with logistic link function for binary outcomes and log link function for count data. We adjusted all models by age, sex, comorbidities, metastases location and presence of multiple tumors at diagnosis, survival in months, and type of tumor-directed treatment.
resultsWe found significant differences in two of the outcomes measured. The likelihood of > 14 hospital days in the last 30 days was significantly higher in rural districts than in remote rural districts (1.27 [1.05, 1.52], p = 0.0003). The number of visits to the GP in the last 30 days of life was significantly lower in urban districts than in remote rural districts (β = - 0.19 [- 0.32, - 0.06], p = <0.0001). No other endpoints were associated with regional differences. Triggering factors for high and low utilization of healthcare were mostly age, comorbidities, and prior anticancer treatment.
conclusionHealthcare utilization and supportive care did not differ significantly between different district types. Results reject the hypothesis of regional inequity in end-of-life care of lung cancer patients in Germany.
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