title: Unequal care for dying patients in Sweden: a comparative registry study of deaths from heart disease and cancer.
abstract: BACKGROUND
  The Swedish Palliative Registry is a nationwide quality registry aimed at facilitating improvement in end-of-life care. The goal is for the registry to list and report quality indicators related to care during the last week of life in all cases expected death in Sweden.
  
  
  OBJECTIVE
  To examine the quality of care during the last week of life as reported to the registry for patients with heart disease compared to those with cancer.
  
  
  METHODS
  A retrospective registry study.
  
  
  RESULTS
  Patients dying of heart disease compared to those dying from cancer had more shortness of breath, fewer drugs prescribed as needed against the usual symptoms and often died alone. Furthermore, they and their close relatives received less information about the imminence of death and bereavement follow-up was less common. The healthcare personnel were less aware of the heart disease patients' symptoms and less often knew about where they wished to die.
  
  
  CONCLUSIONS
  Great differences were found in registered end-of-life care suggesting that the care given to patients with heart disease and cancer was unequal even after adjustment for age, sex and setting at the time of death. If our observational findings are confirmed in future studies there is obviously a need for new models for end-of-life management in order to facilitate the provision of equal care to dying patients regardless of diagnosis.
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden. margareta.brannstrom@nurs.umu.se
authors.forename: Margareta
authors.initials: M
authors.lastname: Brännström
authors.forename: Lena
authors.initials: L
authors.lastname: Hägglund
authors.forename: Carl Johan
authors.initials: CJ
authors.lastname: Fürst
authors.forename: Kurt
authors.initials: K
authors.lastname: Boman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D005260:Female; D054625:Healthcare Disparities; D006331:Heart Diseases / Q000401:mortality / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000628:therapy*; D016017:Odds Ratio; D010166:Palliative Care / Q000592:standards / Q000639:trends*; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D013548:Sweden; D013727:Terminal Care / Q000592:standards / Q000639:trends*; D019452:Terminally Ill