Virtual Library
Start Your Search
Bonnie Leung
Author of
-
+
MA10 - Assessing and Managing Supportive Care Needs (ID 215)
- Event: WCLC 2020
- Type: Mini Oral
- Track: Palliative and Supportive Care
- Presentations: 1
- Moderators:
- Coordinates: 1/31/2021, 11:45 - 12:45, Scientific Program Auditorium
-
+
MA10.11 - End of Life Health Resource Utilization for Limited English Proficient Patients with Advanced NSCLC (ID 1704)
11:45 - 12:45 | Presenting Author(s): Bonnie Leung
- Abstract
Introduction
Immigrants with limited English proficiency (LEP) often encounter communication challenges with their health care team, have poor health literacy, and have difficulty navigating the health care system. In British Columbia, Canada, 28% of the population speak languages other than English in their homes. Due to communication barriers, NSCLC patients with LEP may receive less community palliative home care (CPHC) services and more aggressive end-of-life (EoL) care. The study goals were to observe the difference in health resource utilization at EoL between NSCLC patients who are English proficient (EP) and LEP.
Methods
All patients with advanced NSCLC referred to BC Cancer – Vancouver Centre in 2016 and received medical care were included in the study. Patients seen with a medical interpreter were considered to be LEP. Demographics and clinical information were collected retrospectively. Statistical analysis included the t-test, X2 test, Fisher’s exact test and Mann Whitney U test to compare EP and LEP patients.
Results
186 advanced NSCLC patients were referred. Language of communication: English 66%, Cantonese 21%, Mandarin 6%, Korean 1%, Tagalog 1%, other 5%. Referral to CPHC services was 84% in both groups respectively. There was no difference of the rate of ER visits and hospitalization within 6 months and within 30 days of death between EP and LEP. LEP patients had a higher rate of dying in the tertiary palliative care unit (PCU) or acute care setting, but this was not statistically significant (p=0.335).
ConclusionEnglish Proficient (Interpreters not needed)
(n=122)
Limited English Proficient (Interpreters needed)
(n=64)
p-value
Sex
Female
Male
54 (44%)
68 (56%)
36 (56%)
28 (44%)
0.126
Median Age at Diagnosis (years)
69 (IQR 61-76)
72 (IQR 62-81)
0.225
Community Palliative Home Care
Yes
No
102 (84%)
20 (16%)
54 (84%)
10 (16%)
1.000
Location of Death
Acute Care/Emergency Department
Home/ Long Term Care
Community Hospice Care Facility
Tertiary Palliative Care Unit
22 (18%)
35 (29%)
42 (34%)
23 (19%)
17 (23%)
10 (16%)
22 (34%)
15 (24%)
0.335
Average No. of ER visits within 6 months prior to death
0.89
0.70
0.374
Average No. of Hospitalization within 6 months prior to death
1.40
1.59
0.244
Average No. of ER visits within 30 days prior to death
0.10
0.13
0.640
Average No. of Hospitalization within 30 days prior to death
0.67
0.81
0.091
EP and LEP NSCLC patients had similar rates of access to community based palliative care services and acute care health resource utilization at EoL. LEP patients in this study all received assistance from professional medical interpreters for their oncology appointments, who may have facilitated appropriate discussions between LEP patients and the health care team. Good communication enhances patients and their family’s understanding of the scope of home palliative care services and better prepare them for EoL care.
