Guldin Mai-Britt, Jensen Anders Bonde, Zachariae Robert, Vedsted Peter
Research Unit for General Practice, Aarhus University, Aarhus, Denmark.
Psychooncology. 2013 May;22(5):1152-8. doi: 10.1002/pon.3120. Epub 2012 Jun 29.
Bereavement is likely to result in an increased healthcare utilization. However, little is known about the impact of bereavement on an entire healthcare system, and there is no knowledge of what bereavement requires in terms of healthcare planning. Improved knowledge of patterns of healthcare utilization during bereavement may help optimize targeted support. The objective of this study was to describe patterns of healthcare utilization before and after spousal bereavement because of cancer.
A nationwide population-based case-control study of 6659 bereaved spouses and 66,590 age-matched and gender-matched controls was conducted using data from Danish national registers covering 2 years pre loss to 2 years post loss. Data were obtained on use of services from general practice, psychiatrists, psychologists, hospitals, and consumption of psychotropic medicines.
Bereaved relatives' healthcare utilization and use of medicine increased and peaked around the time of their loss. The rise in healthcare utilization was observable before the loss and during the first years after the loss. A rise was seen in particular in the length of stay at hospitals and in medicine consumption.
Spousal bereavement because of cancer appears to influence healthcare utilization months before the loss and years after the loss. Specific patterns of health care utilization suggest how different periods during the bereavement trajectory generate different needs. This study creates a basis for further research of the patterns of healthcare utilization during bereavement and healthcare planning in palliative care and the adjustment to spousal loss.
丧亲之痛可能导致医疗保健利用率增加。然而，对于丧亲之痛对整个医疗保健系统的影响知之甚少，而且对于丧亲之痛在医疗保健规划方面有哪些需求也不了解。更好地了解丧亲期间的医疗保健利用模式可能有助于优化有针对性的支持。本研究的目的是描述因癌症导致配偶丧亲前后的医疗保健利用模式。
利用丹麦国家登记处涵盖丧亲前2年至丧亲后2年的数据，对6659名丧偶配偶和66590名年龄和性别匹配的对照进行了一项全国性基于人群的病例对照研究。获取了关于全科医疗、精神科医生、心理学家、医院服务使用情况以及精神药物消费的数据。
丧偶亲属的医疗保健利用和药物使用增加，并在丧亲时达到峰值。在丧亲前和丧亲后的头几年，医疗保健利用率的上升是可以观察到的。尤其在住院时间和药物消费方面出现了上升。
因癌症导致的配偶丧亲似乎在丧亲前几个月和丧亲后几年都会影响医疗保健利用。特定的医疗保健利用模式表明了丧亲轨迹的不同阶段如何产生不同的需求。本研究为进一步研究丧亲期间的医疗保健利用模式以及姑息治疗中的医疗保健规划和对配偶丧亲的调整奠定了基础。
