title: End-of-life care for head and neck cancer patients: a population-based study.
abstract: Head and neck cancers (HNCs) usually present a poor prognosis and cause high morbidity rates. Recent surveys have demonstrated that HNC incidence rates are still on the increase in many countries. Our study objective was to assess the end-of-life care for patients with HNCs in Taiwan.
  
  
  
  Data was retrieved from Taiwan's National Health Insurance Research Database, where we identified patients who had been diagnosed with HNCs from January 1997 to December 2010. Each patient's annual trend of opioid use and hospice care needs, along with the distribution of place of death in the study cohort, were all analyzed.
  
  
  
  A total of 98,211 HNC patients diagnosed between 1997 and 2010 were eligible for this study. The majority of HNC patients died in hospital. Patients who were male, lived in capital area, had a higher income, had received palliative hospice care, and had been prescribed opioids tended to choose to die at home or in hospice wards. Both opioid prescription and hospice care have increased during the past 10 years; however, the rate of palliative hospice care remained below 50%.
  
  
  
  Our results demonstrate that greater efforts are needed to implement palliative care for HNC patients in Taiwan.
authors.affiliation: Department of Otolaryngology, Taichung Veterans General Hospital, No. 1650, Sect. 4, Taiwan Boulevard, Taichung, 40705, Taiwan.
authors.forename: Tzu-Lung
authors.initials: TL
authors.lastname: Kuo
authors.affiliation: Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Ching-Heng
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Department of Otolaryngology, Taichung Veterans General Hospital, No. 1650, Sect. 4, Taiwan Boulevard, Taichung, 40705, Taiwan.|Department of Medicine, National Yang-Ming Medical University, Taipei, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Rong-San
authors.initials: RS
authors.lastname: Jiang
authors.affiliation: Department of Otolaryngology, Taichung Veterans General Hospital, No. 1650, Sect. 4, Taiwan Boulevard, Taichung, 40705, Taiwan.|Department of Medicine, National Yang-Ming Medical University, Taipei, Taiwan.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Yen
authors.affiliation: Department of Otolaryngology, Taichung Veterans General Hospital, No. 1650, Sect. 4, Taiwan Boulevard, Taichung, 40705, Taiwan.|Department of Medicine, National Yang-Ming Medical University, Taipei, Taiwan.
authors.forename: Chen-Chi
authors.initials: CC
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology, Taichung Veterans General Hospital, No. 1650, Sect. 4, Taiwan Boulevard, Taichung, 40705, Taiwan. kellyliang1107@gmail.com.|Department of Medicine, National Yang-Ming Medical University, Taipei, Taiwan. kellyliang1107@gmail.com.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan. kellyliang1107@gmail.com.
authors.forename: Kai-Li
authors.identifier: 0000-0002-2530-6685
authors.initials: KL
authors.lastname: Liang
mesh_terms: D018672:Community Health Planning; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000628:therapy*; D017051:Hospice Care / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013727:Terminal Care / Q000523:psychology*
keywords: Head and neck cancer; Neoplasms; Opioid; Pain; Palliative care; Taiwan