Kang Shih-Chao, Hwang Shinn-Jang, Wang Wei-Shu
Division of Family Medicine, National Yang-Ming University Hospital, Yilan, Taiwan, Republic of China Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China.
Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
Am J Hosp Palliat Care. 2014 Aug;31(5):480-4. doi: 10.1177/1049909113492007. Epub 2013 Jun 4.
The utilization of pediatric hospice care remains unclear in Taiwan.
Data were analyzed from the claims of hospice admissions in patients aged 18 years or younger using the National Health Insurance Research Database from 2005 to 2010.
A total of 91 patients and 136 admissions were enrolled (male-female = 50:41; mean 11.6 years old). In all, 62 patients were admitted once, including 47 patients who died. All the patients had cancer, with brain cancer (40.7%) accounting the most . Among acute comorbidities, neurological complications (16.2%) were mostly accounted. Family physicians provided most (64.7%) of the hospice services. Hospice stay ≤3 days correlated positively with death in hospices (odds ratio = 2.922, 95% confidence interval = 1.268-6.730).
Pediatric hospice care revealed characteristics different from adults. Underlying late referrals were prevalent. There is space to promote the utilization of hospices for terminally ill pediatric patients.
台湾地区儿童临终关怀服务的利用情况尚不清楚。
利用2005年至2010年的全民健康保险研究数据库，对18岁及以下临终关怀住院患者的理赔数据进行分析。
共纳入91例患者和136次住院（男∶女 = 50∶41；平均年龄11.6岁）。其中，62例患者仅住院1次，包括47例死亡患者。所有患者均患有癌症，其中脑癌占比最高（40.7%）。在急性合并症中，神经并发症占比最大（16.2%）。家庭医生提供了大部分（64.7%）的临终关怀服务。临终关怀住院时间≤3天与在临终关怀机构死亡呈正相关（优势比 = 2.922，95%置信区间 = 1.268 - 6.730）。
儿童临终关怀服务呈现出与成人不同的特点。潜在的延迟转诊情况普遍存在。在促进为身患绝症的儿童患者提供临终关怀服务方面仍有提升空间。
