Department of Family Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, 123, Ta-Pei Rd, Niao-Song Hsiang, Kaohsiung Hsien, Taiwan.
Cancer Nurs. 2011 May-Jun;34(3):E21-6. doi: 10.1097/NCC.0b013e3181ff78b6.
Decisions for the type of palliative care are affected by multiple factors. Currently, most patients die without palliative care, and hospice patients receive only a brief period of services before death.
This study aimed to compare palliative terminal cancer care in inpatient hospice and nonhospice care units in Taiwan for type of cancer, cost, stay, and selected demographic and clinical characteristics.
A retrospective study of terminally ill cancer patients hospitalized in a hospice unit (410 patients) or a general cancer ward (3005 patients) in a hospital in Taiwan was conducted. Patient demographic information, length of stay, cost of treatments, interventions and diagnostic testing, and types of cancer were analyzed. The factors associated with hospice care were revealed by multivariate stepwise regression.
In the hospice group, the total cost was lower; there were more female, and more head, neck, and lung tumor patients. The most tumors in nonhospice group are hepatomas. The patients in hospice group received fewer interventions and had a long hospital stay (>14 days) before death; however, most of them were discharged from the hospital due to death.
Utilization of hospice care varies by sex and type of cancer. Compared with the nonhospice service, hospice care needs a lower total cost and fewer interventions.
Hospice care in Taiwan should provide more services and facilities specific for sex (female) and tumors (head and neck).
姑息治疗的类型决策受到多种因素的影响。目前，大多数患者在没有姑息治疗的情况下死亡，而临终关怀患者在死亡前仅接受短暂的服务。
本研究旨在比较台湾住院临终关怀和非临终关怀病房中晚期癌症患者的姑息治疗类型、成本、住院时间和选定的人口统计学和临床特征。
对台湾一家医院临终关怀病房（410 例）和普通癌症病房（3005 例）住院的终末期癌症患者进行回顾性研究。分析患者的人口统计学信息、住院时间、治疗费用、干预措施和诊断性检查以及癌症类型。通过多变量逐步回归揭示与临终关怀相关的因素。
在临终关怀组中，总费用较低；女性患者较多，头颈部和肺部肿瘤患者较多。非临终关怀组中最常见的肿瘤是肝癌。临终关怀组的患者在死亡前接受的干预措施较少，住院时间较长（>14 天）；然而，他们中的大多数人因死亡而出院。
姑息治疗的使用因性别和癌症类型而异。与非临终关怀服务相比，临终关怀需要较低的总成本和较少的干预措施。
台湾的临终关怀服务应提供更多针对性别（女性）和肿瘤（头颈部）的特定服务和设施。
