Ida E, Miyachi M, Uemura M, Osakama M, Tajitsu T
Social Service Organization, Mikokoro Hospice, Sacred Heart of Jesus Hospital, Kumamoto City, Japan.
Palliat Med. 2002 May;16(3):179-84. doi: 10.1191/0269216302pm511oa.
In Japan, the first government-approved hospice (GAH) and palliative care unit was established and commenced operations in 1990, and hospice medical care was made eligible for health insurance coverage. By 31 December 2000, the number of GAH institutions had increased to 86 (1,590 beds). The ratio of hospices to population in Japan is currently approximately 1:1.5 million, with an average of one hospice bed for approximately every 80,000 people. This study of institutions reports a survey conducted to determine the number of deaths (hospice unit and home) of GAH cancer patients, and to determine the servicing status of hospice home care for the period 1995 through 2000. The place of death of the patients cared for by GAHs in 2000 were: hospice units 97.7% and home 2.3%. GAH patient deaths (both inpatient and at home) in 2000 was 2.6% of the total number of cancer patients' deaths, an increase of 3.8-fold since 1995. Of the total number of GAH institutions, 62% are engaged in home care services and 91 % offer hospice care by hospice-assigned doctors. In addition, 72% offer team care with nurses based at Home Care Agencies. In order for the hospice (including home care service) to become established in a way most appropriate to each region of Japan, GAH institutions must assume significant promotional roles in their respective regions. One of the goals and assignments of establishing medical service with hospice home care in Japan is to develop the systematic care programs of GAH institutions, which include home care service in addition to the already established hospice unit and outpatient services.
在日本，首个政府批准的临终关怀机构（GAH）及姑息治疗病房于1990年设立并开始运营，临终关怀医疗服务被纳入医疗保险覆盖范围。截至2000年12月31日，GAH机构数量增至86家（1590张床位）。目前日本临终关怀机构与人口的比例约为1:150万，平均每8万人拥有一张临终关怀床位。本机构研究报告了一项调查，旨在确定GAH癌症患者的死亡人数（临终关怀病房及家中），并确定1995年至2000年期间临终关怀居家护理的服务状况。2000年由GAH照料的患者的死亡地点为：临终关怀病房97.7%，家中2.3%。2000年GAH患者死亡人数（住院及家中）占癌症患者死亡总数的2.6%，自1995年以来增长了3.8倍。在GAH机构总数中，62%从事居家护理服务，91%由临终关怀指定医生提供临终关怀护理。此外，72%通过居家护理机构的护士提供团队护理。为使临终关怀（包括居家护理服务）以最适合日本各地区的方式得以确立，GAH机构必须在各自地区发挥重要的推广作用。在日本建立含临终关怀居家护理的医疗服务的目标和任务之一，是制定GAH机构的系统护理计划，其中除已设立的临终关怀病房及门诊服务外，还包括居家护理服务。
