{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:33:30Z","timestamp":1793115210041,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2019,9,25]],"date-time":"2019-09-25T00:00:00Z","timestamp":1569369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The care pathway of patients with colorectal cancer (CRC) 1\u00a0year prior to death, their causes of death and the healthcare use, and associated expenditure remain poorly described together. People managed for CRC (2014\u20102015), covered by the national health insurance general scheme and who died in 2015 were selected from the national health data system. A total of 15\u00a0361 individuals (mean age: 75\u00a0years, SD: 12.5\u00a0years) were included, almost 66% of whom died in short\u2010stay hospital (SSH), 9% in hospital at home (HaH), 4% in rehabilitation units (Rehab), 6% in skilled nursing homes (SNH), and 15% at home. At least one other cancer was identified for one\u2010third of these people. Almost one\u2010half of people presented cardiovascular comorbidity, 21% had chronic respiratory disease, and 13% had a neurological or degenerative disease. During the last month of life, 83% were admitted at least once to SSH, 39% had at least one emergency department admission, 17% were admitted to an intensive care unit, 15% received at least one chemotherapy session (&lt;60\u00a0years: 27%), and 5% received oral chemotherapy. Eighty\u2010eight percent of the 60% of individuals who received hospital palliative care (HPC) vs 75% of those without HPC were admitted to SSH at least once during the last month. Cancer was the main cause of death for 84% (SSH: 85%, home: 77%) and corresponded to CRC for 64% of them. The mean annual expenditure per person during the last year of life was \u20ac43\u00a0398 (SSH: \u20ac48\u00a0804). This study suggests a relatively high level of HPC use during the year before death for people with CRC in France. High rates of emergency department, intensive care, and chemotherapy use were observed during the last month of life. However, management is very largely SSH\u2010based with a small proportion of deaths at home.<\/jats:p>","DOI":"10.1002\/cam4.2527","type":"journal-article","created":{"date-parts":[[2019,9,25]],"date-time":"2019-09-25T21:08:51Z","timestamp":1569445731000},"page":"6671-6683","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Management and intensity of medical end\u2010of\u2010life care in people with colorectal cancer during the year before their death in 2015: A French national observational study"],"prefix":"10.1002","volume":"8","author":[{"given":"Audrey","family":"Tanguy\u2010Melac","sequence":"first","affiliation":[{"name":"Caisse Nationale d'Assurance Maladie (Cnam) \u2013 Direction de la strat\u00e9gie des \u00e9tudes et des statistiques Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Sophie","family":"Aguade","sequence":"additional","affiliation":[{"name":"Caisse Nationale d'Assurance Maladie (Cnam) \u2013 Direction de la strat\u00e9gie des \u00e9tudes et des statistiques Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Fagot\u2010Campagna","sequence":"additional","affiliation":[{"name":"Caisse Nationale d'Assurance Maladie (Cnam) \u2013 Direction de la strat\u00e9gie des \u00e9tudes et des statistiques Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Gastaldi\u2010M\u00e9nager","sequence":"additional","affiliation":[{"name":"Caisse Nationale d'Assurance Maladie (Cnam) \u2013 Direction de la strat\u00e9gie des \u00e9tudes et des statistiques Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Marc","family":"Sabat\u00e9","sequence":"additional","affiliation":[{"name":"Service de Gastroent\u00e9rologie H\u00f4pital Avicenne AP\u2010HP Bobigny France"},{"name":"INSERM U\u2010987 Physiopathologie et Pharmacologie Clinique de la Douleur H\u00f4pital Ambroise Par\u00e9 Boulogne\u2010Billancourt France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5698-9215","authenticated-orcid":false,"given":"Philippe","family":"Tuppin","sequence":"additional","affiliation":[{"name":"Caisse Nationale d'Assurance Maladie (Cnam) \u2013 Direction de la strat\u00e9gie des \u00e9tudes et des statistiques Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,9,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39535.491238.94"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.58.6362"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62416-2"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzi061"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2012.09.013"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2015.004416"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2016.03.008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2015-000997"},{"key":"e_1_2_7_10_1","unstructured":"Plan triennal 2015\u20102018 pour le d\u00e9veloppement des soins palliatifs et l'accompagnement en fin de vie. 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