Integrated palliative medicine in public oncology: a 10-year review

Author:

Chan Sik KwanORCID,Lam Tai Chung,Choi Horace Cheuk-Wai,Tsang Ka Chun,Yuen Kwok-Keung,Soong Inda,Wong Kam Hung,Lui Louisa,Lo Sing Hung,Tong Macy,Lo Raymond,Lam Po Tin,Lam Wai Man,Li Bryan

Abstract

ObjectivesThe rapid ageing population of Hong Kong has a high demand on oncology and palliative care (PC) service. This study was the first territory-wide assessment in Hong Kong to assess the palliative service coverage in patients with advanced cancer in the past decade.MethodsCancer deaths of all 43 public hospitals of Hong Kong were screened. Randomly selected 2800 cancer deaths formed a representative cohort in all seven service clusters of Hospital Authority at 4 time points (2006, 2009, 2012, 2015). Individual patient records were thoroughly reviewed. Predictors of PC coverage was evaluated in univariable and multivariable analyses.ResultsFrom 2006 to 2015, PC coverage improved steadily from 55.4% to 68.9% (p<0.001). Median time of referral to PC service to death was 25 days (IQR: 53). For duration of inpatient PC, the median time was 22 days (IQR: 44) and it was stable over the past 10 years. Median time of referral to outpatient service to death was 74 days (IQR: 144) and there was an improvement observed (p<0.05). The current system was highly heterogeneous that PC varied between 9.8% and 84.8% in different hospitals depending on the PC service infrastructure. Multivariable Cox model identified patients associated with lower PC coverage: male, <50, rapid disease deterioration and staying in hospitals without multidisciplinary team clinic and designated palliative bed support (all p<0.01).ConclusionThere was concrete achievement in palliative service development in the past decade. Heterogeneity and late service provision should be addressed in future.

Publisher

BMJ

Subject

Medical–Surgical Nursing,Oncology (nursing),General Medicine,Medicine (miscellaneous)

Reference20 articles.

1. Hong Kong cancer registry (Retrieved 20 March 2019).

2. Concepts and definitions for “supportive care,” “best supportive care,” “palliative care,” and “hospice care” in the published literature, dictionaries, and textbooks

3. Chan CLW , Chow AMW . Death, dying and bereavement: the Hong Kong Chinese experience. Hong Kong University Press, 2005.

4. The impact of palliative care on cancer deaths in Hong Kong: a retrospective study of 494 cancer deaths

5. Two decades of palliative care;Chan;Hong Kong Med J,2002

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3