Factors Associated With Non-Beneficial Treatments in End of Life Hospital Admissions: A Multicentre Retrospective Cohort Study in Australia

Carter, Hannah Elizabeth, Lee, Xing Ju, Gallois, Cindy, Winch, Sarah, Callaway, Leonie, Willmott, Lindy, White, Ben, Parker, Malcolm, Close, Eliana, & Graves, Nicholas (2019) Factors associated with non-beneficial treatments in end of life hospital admissions: A multicentre retrospective cohort stud

18 Pages Posted: 18 Dec 2019

See all articles by Hannah Carter

Hannah Carter

Queensland University of Technology

Xing Ju Lee

Queensland University of Technology - Institute of Health and Biomedical Innovation

Cindy Gallois

University of Queensland

Sarah Winch

University of Queensland

Leonie Callaway

University of Queensland

Lindy Willmott

Queensland University of Technology - Faculty of Law

Ben White

Queensland University of Technology - Faculty of Law

Malcolm Parker

University of Queensland - School of Medicine

Eliana Close

Queensland University of Technology

Nicholas Graves

Queensland University of Technology

Date Written: November 4, 2019

Abstract

Objective: To quantitatively assess the factors associated with non-beneficial treatments (NBTs) in hospital admissions at the end of life.

Design: Retrospective multicentre cohort study.

Setting: Three large, metropolitan tertiary hospitals in Australia.

Participants: 831 adult patients who died as inpatients following admission to the study hospitals over a 6-month period in 2012.

Main outcome measures: Odds ratios (ORs) of NBT derived from logistic regression models.

Results: Overall, 103 (12.4%) admissions involved NBTs. Admissions that involved conflict within a patient’s family (OR 8.9, 95% CI 4.1 to 18.9) or conflict within the medical team (OR 6.5, 95% CI 2.4 to 17.8) had the strongest associations with NBTs in the all subsets regression model. A positive association was observed in older patients, with each 10-year increment in age increasing the likelihood of NBT by approximately 50% (OR 1.5, 95% CI 1.2 to 1.9). There was also a statistically significant hospital effect.

Conclusions: This paper presents the first statistical modelling results to assess the factors associated with NBT in hospital, beyond an intensive care setting. Our findings highlight potential areas for intervention to reduce the likelihood of NBTs.

Keywords: end-of-life care, non-beneficial treatment, health, end-of-life treatment, end-of-life decision making

JEL Classification: I1, I19, I12

Suggested Citation

Carter, Hannah and Lee, Xing Ju and Gallois, Cindy and Winch, Sarah and Callaway, Leonie and Willmott, Lindy and White, Ben and Parker, Malcolm and Close, Eliana and Graves, Nicholas, Factors Associated With Non-Beneficial Treatments in End of Life Hospital Admissions: A Multicentre Retrospective Cohort Study in Australia (November 4, 2019). Carter, Hannah Elizabeth, Lee, Xing Ju, Gallois, Cindy, Winch, Sarah, Callaway, Leonie, Willmott, Lindy, White, Ben, Parker, Malcolm, Close, Eliana, & Graves, Nicholas (2019) Factors associated with non-beneficial treatments in end of life hospital admissions: A multicentre retrospective cohort stud, Available at SSRN: https://ssrn.com/abstract=3486685

Hannah Carter

Queensland University of Technology ( email )

2 George Street
Brisbane, Queensland 4000
Australia

Xing Ju Lee

Queensland University of Technology - Institute of Health and Biomedical Innovation ( email )

2 George Street
Brisbane, Queensland 4000
Australia

Cindy Gallois

University of Queensland ( email )

St Lucia
Brisbane, Queensland 4072
Australia

Sarah Winch

University of Queensland ( email )

St Lucia
Brisbane, Queensland 4072
Australia

Leonie Callaway

University of Queensland ( email )

St Lucia
Brisbane, Queensland 4072
Australia

Lindy Willmott

Queensland University of Technology - Faculty of Law ( email )

Level 4, C Block Gardens Point
2 George St
Brisbane, QLD 4000
Australia

HOME PAGE: http://staff.qut.edu.au/staff/willmott/

Ben White (Contact Author)

Queensland University of Technology - Faculty of Law ( email )

Level 4, C Block Gardens Point
2 George St
Brisbane, QLD 4000
Australia

HOME PAGE: http://staff.qut.edu.au/staff/whiteb/

Malcolm Parker

University of Queensland - School of Medicine ( email )

St Lucia
Queensland 4072
Australia

Eliana Close

Queensland University of Technology ( email )

2 George Street
Brisbane, Queensland 4000
Australia

Nicholas Graves

Queensland University of Technology ( email )

2 George Street
Brisbane, Queensland 4000
Australia

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