Delivery of health care at the end of life in cancer patients of four swiss cantons a retrospective database study (SAKK 89/09)

Background The use of cancer related therapy in cancer patients at the end-of-life has increased over time in many countries. Given a lack of published Swiss data, the objective of this study was to describe delivery of health care during the last month before death of cancer patients. Methods Claims data were used to assess health care utilization of cancer patients (identified by cancer registry data of four participating cantons), deceased between 2006-2008. Primary endpoints were hospitalization rate and delivery of cancer related therapies during the last 30 days before death. Multivariate logistic regression assessed the explanatory value of patient and geographic characteristics. Results 3809 identified cancer patients were included. Hospitalization rate (mean 68.5%, 95%CI 67.0-69.9) and percentage of patients receiving anti-cancer drug therapies (ACDT, mean 14.5%, 95%CI 13.4-15.6) and radiotherapy (mean 7.7%, 95%CI 6.7-8.4) decreased with age. Canton of residence and insurance type status most significantly influenced the odds for hospitalization or receiving ACDT. Conclusions The intensity of cancer specific care showed substantial variation by age, cancer type, place of residence and insurance type status. This may be partially driven by cultural differences within Switzerland and the cantonal organization of the Swiss health care system.

Hebräische Schule (Lemle Moses'sche Klausstiftung) in Mannheim : Jahresbericht f. d. Schuljahr 1888/89 ; zugleich als Einladung zu d. am Sonntag, den 7. April 1889 stattfindenen öffentl. Prüfung ; voran geht: Rede bei d. Einweihung d. neuerbauten Klaussynagoge am 28. Nov. 1888 (24. Kislev 5549 a. m.)

M. Appel

Cancer-related therapies at the end of life in hospitalized cancer patients from four Swiss cantons: SAKK 89/09.

The use of cancer-related therapies in cancer patients hospitalized at the end of life has increased in many countries over time. Given the scarcity of published Swiss data, the objective of this study was to evaluate the influence of hospital type and other factors on the delivery of health care during the last month before death. Claims data were used to assess health care utilization of cancer patients (identified by cancer registry data of four participating Swiss cantons) who deceased between 2006 and 2008. Primary endpoints were delivery of cancer-related therapies during the last 30 days before death. Multivariate logistic regression assessed the explanatory value of hospital type, patient and geographic characteristics. Of 3,809 identified cancer patients in the claims database, 2,086 patients dying from cancer were hospitalized during the last 30 days before death, generating 2,262 inpatient episodes. Anticancer drug therapy was given in 22.2% and radiotherapy in 11.7% of episodes. Besides age and cancer type, the canton of residence and hospital type showed independent, statistically significant associations with intensity of care, which was highest in university hospitals. These results should initiate a discussion among oncologists in Switzerland and may question the compliance with standard of care guidelines for terminal cancer patients.

Ms. hebr. oct. 89 - Mivḥar ha-peninim

Vorbesitzer: Isaachi Castelnuovo; Elia Castelnuovo; Angelo Castelnuovo; Abraham Merzbacher

Ms. Barth. 89 - In quartum Sententiarum

Vorbesitzer: Bartholomaeusstift Frankfurt am Main

Days spent in acute care hospitals at the end of life of cancer patients in four Swiss cantons: a retrospective database study (SAKK 89/09).

Number of days spent in acute hospitals (DAH) at the end of life is regarded as an important care quality indicator for cancer patients. We analysed DAH during 90 days prior to death in patients from four Swiss cantons. Claims data from an insurance provider with about 20% market share and patient record review identified 2086 patients as dying of cancer. We calculated total DAH per patient. Multivariable generalised linear modelling served to evaluate potential explanatory variables. Mean DAH was 26 days. In the multivariable model, using complementary and alternative medicine (DAH = 33.9; +8.8 days compared to non-users) and canton of residence (for patient receiving anti-cancer therapy, Zürich DAH = 22.8 versus Basel DAH = 31.4; for other patients, Valais DAH = 22.7 versus Ticino DAH = 33.7) had the strongest influence. Age at death and days spent in other institutions were additional significant predictors. DAH during the last 90 days of life of cancer patients from four Swiss cantons is high compared to most other countries. Several factors influence DAH. Resulting differences are likely to have financial impact, as DAH is a major cost driver for end-of-life care. Whether they are supply- or demand-driven and whether patients would prefer fewer days in hospital remains to be established.

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 89 - Brief über die Freundschaft mit Schopenhauer

veröffentlicht in: Schopenhauer, Arthur : Arthur Schopenhauers sämtliche Werke - München : Piper - Bd. 14 : Der Briefwechsel Arthur Schopenhauers ; 1 (1799 - 1849), Nr. 20;

Na 1 Nachlass Max Horkheimer, 76 - Korrespondenzen u.a. mit Hermann Igersheimer (p. II 9, 89-222c)

1 Brief und Beilage vom Institut für sozialwissenschaftliche Forschung Darmstadt an Max Horkheimer, 1949; 82 Briefe zwischen Hermann Igersheimer und Max Horkheimer, 1941-1950; 5 Briefe zwischen Harold E. Jones von der University of California und Max Horkheimer, 1947; 1 Brief von Morris Janowitz an Max Horkheimer, 1948; 2 Briefe vom Jewish Community Center an Max Horkheimer, 1948; 7 Briefe zwischen Robert P. St.John und Max Horkheimer, 1945; 2 Briefe zwischen Erich von Kahler und Max Horkheimer, 1945; 2 Briefe und Beilage zwischen Anselm Kahn und Max Horkheimer, 04.07.1945, 19.07.1945;

Na 1 Nachlass Max Horkheimer, 302 - Korrespondenzen u.a. mit Arthur Hübscher (p. V 89, 51-199)

83 Briefe und Beilagen zwischen Arthur Hübscher und Max Horkheimer, 1963-1973; 15 Briefe und Beilagen zwischen Bundesminister a. D. Ewald Bucher und Max Horkheimer, 1966-1971; 1 Brief und Beilage von Dr. Christoph Meyer an Max Horkheimer, 1969; 6 Briefe zwischen Dr. Johann Joeden und Max Horkheimer, 1966; 5 Briefe zwischen dem Oberregierungsrat Gustav Adolf Hünniger und Max Horkheimer, 1951-1953; 2 Briefe und eine Empfehlung und ein Gutachten von Edith Hünniger an Max Horkheimer, 1952-1953;

Ms. Praed. 89 - Tabula Decretalium et Sexti

Vorbesitzer: Dominikanerkloster Frankfurt am Main

Ms.Ff.F.Stoltze 3. 89 - Brief von Johann Friedrich Gerhard an Friedrich Stoltze

Persönliche Nachrichten, Stoltze, Alexander Gwinner

Ausst. 89 - Die Leidenswerkzeuge Christi, das Heilige Grab mit Magdalena und zwei Heilige

Vorbesitzer: Augustinerkloster Mariastein bei Eichstätt; Bartholomaeusstift Frankfurt am Main;

Ms. lat. qu. 89 - Pitture in S. Calisto di Roma

Vorbesitzer: Michelangelo Gualandi;