The impact of hospice combined care on the utilization of hospice services

• Main Authors: Ching-Yi Yeh, 葉青宜
• Other Authors: Che-Ming Yang
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/19705619854458455862

碩士 === 臺北醫學大學 === 醫務管理學研究所 === 98 === Objective:Cancer has been the leading cause of death in Taiwan for more than 20 years, not only the casualty continues to increase, and consumes many medical resources. The World Health Organization had already confirmed hospice care is the best attendance way for cancer patients. Hospice care has been practiced in Taiwan for many years, but the result is not still good. Therefore the Department of Bureau of Health Promotion has launched a hospice combined care project since 2005 to promote the hospice care covering rate.The purpose of this study is to explore the impact of this project on the utilization of hospital-based hospice care and home hospice care in national and six districts. Methods:The study subjects were terminal cancer patients who had used hospice care and home hospice care between 2003 and 2007. The statistical method of the study is time series models.By selecting the appropriate ARIMA models in the utilization of hospice care and home hospice care, then intervention analysis was used to examine the impact on the utilization of hospice services when hospice combined care projec was implemented in national and six districts. Results: The outcome of intervention analysis found that hospice combined care project had a significant impact on the utilization of hospice care (including visits, persons and length of stay), but had a insignificant impact on the utilization of home hospice care(including visits and persons) and average length of stay.This policy produce different impact in various districts. The impact on the utilization of hospice care is perhaps related with various districts medical service resources distribution. The impact on the utilization of home hospice care is perhaps related with nursing manpower, cancer patient''s condition and their own choice as well as the lower payment. Utilization of home hospice care still waited for strengthening. Conclusion: Hospice care may alleviate the ache effectively, reduce the family member to regret and the lamentation and finally improve end-of-life quality for cancer patients. In addition, stops non-essential medical intervention and use of cardiopulmonary resuscitation, saves down the medical resources, might use in other having the cure opportunity, and needs the aggressive treatment patients, is item of advantageous, simultaneously also advantageous society''s choice.