Institute of Public Health, University of Cambridge, Cambridge, UK.
Palliat Med. 2010 Sep;24(6):641-50. doi: 10.1177/0269216310364199. Epub 2010 Apr 15.
The equitable provision of care is a core principle of the National Health Service. Previous research has suggested that older cancer patients may be less likely to use specialist palliative care, but such research has been limited by retrospective design and the failure to measure clinical need. The objective of this study was to examine the extent to which the use of specialist palliative care in lung cancer patients varies by age, after accounting for need. A cross-sectional survey of patients and their carers attending four hospital lung cancer clinics in London was conducted between June 2006 and April 2007. Two hundred and fifty-two patients and 137 carers participated in the study. Thirty-nine percent of participants received specialist palliative care. Metastatic disease, global quality of life and the clinic where treatment was provided were associated with use of specialist palliative care. Age, gender, deprivation, living alone, current or most recent line of treatment, number of co-morbidities and carer stress were not associated with receipt of such services. This suggests that, for patients within the specialist cancer care system, access to specialist palliative care is offered on the basis of need.
公平提供医疗服务是国民保健制度的核心原则。先前的研究表明，老年癌症患者可能不太可能使用专科姑息治疗，但这类研究受到回顾性设计和未能衡量临床需求的限制。本研究的目的是，在考虑到需求的情况下，检查肺癌患者使用专科姑息治疗的程度是否因年龄而异。2006 年 6 月至 2007 年 4 月期间，在伦敦的四家医院肺癌诊所对患者及其护理人员进行了横断面调查。252 名患者和 137 名护理人员参与了这项研究。39%的参与者接受了专科姑息治疗。转移性疾病、全球生活质量和提供治疗的诊所与专科姑息治疗的使用相关。年龄、性别、贫困、独居、当前或最近的治疗线、合并症的数量和护理人员的压力与获得此类服务无关。这表明，在专科癌症护理系统内的患者，专科姑息治疗的提供是基于需求的。
