Trend In Treatment Aggressiveness At The End Of Life In An Italian Homogeneous Area: Preliminary Data.

e18227 Background: To assess the attitude of physicians in treating with antineoplastic treatments patients with advanced cancer at the end of life. Methods: The records of all cancer patients deceased in Romagna in 2013 were reviewed. For all the patients were reported name, sex, age in 2013, kind of disease, kind of treatment, date of the last administration of chemotherapy, date of death, cumulative costs of the antineoplastic treatments. Primary aim of the trial was to assess the length from the last administration of chemotherapy and death; secondary end points were to assess the differences in the different districts of the Area, the kind and the costs of the treatments. The results are the preliminary phase of an integrated process of audit in the area on the effectiveness of the integration of oncology and palliative care on the comprehensive quality of care in favor of patients with advanced cancer. Results: Romagna is an homogeneous area of the north-east of Italy accounting 1123093 inhabitants and 3460 deaths for cancer in 2013 (3.08x10-3 inhabitants). Three districts with 2 oncologic departments and 1 cancer center exist in the area, with respectively 335199, 391997 and 395897 inhabitants and 967, 1293 and 1200 deaths for cancer in 2013 (2.88, 3.29 and 3.13x10-3inhabitants). The number of the patients treated in the last 30 and 14 days of life and the cumulative costs of the treatment are reported in the table. Conclusions: Our preliminary data confirms the attitude of clinicians in treating patients until the last part of life. This attitude probably reduces the comprehensive quality of the care, but does not seem to represent a significant factor increasing the costs of the treatments. The differences between the districts, although partly due to the different vocations of the centers probably need a clinical audit to assess the reasons of the phenomenon. Center Treated in the last 30 days of life Cumulative costs (x 1000€) Treated in the last 14 days of life Cumulative costs (x 1000€) District 1 34 (10.97%) 18.293 14 (4.52%) 9.337 District 2 60 (13.27%) 118.513 22 (4.87%) 39.480 Cancer Center 128 (25.81%) 81.904 62 (12.5%) 28.847 Romagna 222 (17.64%) 218.71 98 (7.79%) 77.665