National Cancer Control Institute, National Cancer Center, Seoul, Republic of Korea.
J Pain Symptom Manage. 2011 Apr;41(4):692-9. doi: 10.1016/j.jpainsymman.2010.06.019. Epub 2011 Jan 13.
Although timely referral to palliative care services can help improve quality of life by minimizing patient and family suffering during a life-threatening illness, it remains unclear whether patients in Korea who suffer from advanced cancer are referred to palliative care services in a timely manner.
We aimed to investigate the timeliness of patient referral to palliative care services in Korea by examining the duration of survival after enrollment and identify the factors contributing to earlier or later referral.
Patient- and episode-level data were collected from 3867 terminal cancer patients, who were registered in 34 inpatient palliative care services designated by the Ministry of Health, Welfare, and Family Affairs. Cox proportional hazard models were used to determine factors associated with the duration of survival after enrollment in palliative care services.
The median duration of survival after enrollment in palliative care services was 18 days. Male sex, liver cancer diagnosis, poor performance status, being covered by National Health Insurance, and being married were significantly associated with shorter duration of survival after enrollment, whereas a prostate cancer diagnosis was associated with longer survival.
Korean terminal cancer patients are referred to palliative care very late, and the timing appears to be influenced by some socioeconomic and medical factors. Interventions, such as physician education and establishing palliative care teams, are required to promote earlier referrals in Korea.
尽管及时转介到姑息治疗服务可以通过最大限度地减少危及生命的疾病期间患者和家庭的痛苦来提高生活质量，但目前仍不清楚韩国患有晚期癌症的患者是否及时转介到姑息治疗服务。
通过检查登记后生存时间，我们旨在调查韩国患者转介到姑息治疗服务的及时性，并确定导致更早或更晚转介的因素。
从卫生福利部指定的 34 个住院姑息治疗服务中登记的 3867 名终末期癌症患者中收集了患者和疾病发作水平的数据。使用 Cox 比例风险模型确定与姑息治疗服务登记后生存时间相关的因素。
姑息治疗服务登记后生存时间的中位数为 18 天。男性、肝癌诊断、较差的表现状态、参加国家健康保险和已婚与登记后生存时间较短显著相关，而前列腺癌诊断与较长的生存时间相关。
韩国的终末期癌症患者被转介到姑息治疗服务非常晚，时机似乎受到一些社会经济和医疗因素的影响。需要采取干预措施，如医生教育和建立姑息治疗团队，以促进韩国的早期转介。
