Systemic Treatment in the Last 30 Days of Life
Identifying Attributes
Care Settings
Country
Publishing Organisation
Type of Quality Indicator
IOM Quality Dimension
Domain
Defining Attributes
Definition
Systemic treatment in the last 30 days of life is an indicator of aggressive end-of-life care and has been found not to improve quality of life.
Numerator
Those in the denominator who received palliative antineoplastic systemic treatment in their last 30 days of life
Denominator
Number of people who died within the specified time period, who had a breast, cervix, colorectal, lung or prostate cancer diagnosis and had a medical oncology (MO) visit in their last year of life
Exclusions
Denominator Exclusions: Deaths due to suicide or medical assistance in dying Patients who died outside Ontario Patients <18 years at time of death Invalid health card number Patients with multiple primaries Patients who did not have a malignant cancer diagnosis in the Ontario Cancer Registry Diagnosis of cancer based solely on the death certificate Patients with acute leukaemia (e.g., Acute Lymphocytic Leukaemia, Acute Myeloid Leukaemia, Acute Monocytic Leukaemia, Other Acute Leukaemia) Patients whose deaths occurred within 30 days of a major cancer-related operative procedure Patients who did not have a medical oncologist visit/consult in the last year of life
Numerator Exclusion: Hormonal systemic therapy drugs using the ALR antineoplastic classification list
Use of Risk Adjustment
Risk Adjustments
None
Stratifications
Collection and Reporting Attributes
Type of Data Collection
Data Collection Methods
Data are sourced from Ontario Cancer Registry (OCR), Discharge Abstract Data (DAD), National Ambulatory Care Reporting System (NACRS), Registered Persons Database (RPDB), Activity Level Reporting (ALR) amd Ontario Health Insurance (OHIP)