National Survey on the Availability of Oncology Palliative Care Services at Tertiary General and Cancer Hospitals in China

Abstract

Abstract Purpose: The nationwide survey studied the level of palliative care (PC) access for Chinese patients with cancer among cancer care providers either in tertiary general hospitals or cancer hospitals in China. Methods:Using a probability-proportionate-to-size method, local tertiary general hospitals with oncology departments were identified to match cancer hospitals. A PC program leader or a designee per hospital reported the PC services, including staffing, inpatient and outpatient services, education, and research, based on questions adapted from a previous national survey on PC. The primary outcome was availability of a PC service. Results: From responders, most hospitals reported that some type of PC service was available (84.3% of tertiary general hospitals, 82.8% of cancer hospitals), although named as “comprehensive cancer care”, “pain and symptom management” or “supportive care”. However, cancer hospitals were significantly more likely than tertiary general hospitals to have a PC department or specialist (34.1% compared with 15.5%, p<0.001). The most popular services were pain consultation (>92%), symptom management (>77%), comprehensive care plans (~60%), obtaining advanced directives and do-not-resuscitate (DNR) orders (~45%), referrals to hospice (>32%), and psychiatric assessment (>25%). Cancer hospitals were also more likely than tertiary general hospitals to report having inpatient beds for PC (46.3% compared with 30.5%; p=0.010), outpatient PC clinics (28.0% compared with 16.8%; p=0.029), educational programs (18.2% compared with 9.0%, p=0.014), and research programs (17.2% compared with 9.3%, p<0.001). Conclusion: Cancer hospitals have greater availability of PC than do tertiary general hospitals in China. Our findings highlight opportunities to further increase the PC capacity in Chinese hospitals.