Deamant Catherine D, Liu Elaine, Hinami Keiki, Weinstein Robert A, Trick William E
Cook County Health and Hospitals System , Chicago, Illinois.
J Palliat Med. 2015 Mar;18(3):251-8. doi: 10.1089/jpm.2014.0267. Epub 2014 Dec 3.
With unprecedented levels of international migration, physicians in the United States may care for terminally ill patients who have strong connections to their country of origin and such patients may desire to return in the final stages of life.
In this study, we analyzed how often terminally ill patients cited travel to country of origin as a goal of care, how often travel occurred, and factors associated with successful travel.
A retrospective chart review from January 1, 2005 through May 1, 2007.
SETTING/SUBJECTS: All foreign-born patients seen by a palliative care consultation service, including inpatient and outpatient consultations, in an urban safety-net health system in the United States.
We determined whether patients expressed a desire to travel to their country of origin and the factors, including demographics and functional status associated with travel.
Of 336 foreign-born patients, 129 (38%) expressed a desire to travel to their country of origin; 60 (47%) successfully returned to 24 unique countries. Countries to which the largest number of patients returned were Mexico (n=14), Poland (n=11), and the Philippines (n=7). Although patients with the best functional status were most likely to travel successfully, 16 (31%) who wanted to travel despite having the worst functional status (Eastern Cooperative Oncology Group [ECOG] score indicating confinement to bed or chair) traveled successfully. There were no deaths en route or flight diversions due to medical crisis; all trips were made on regularly scheduled commercial airline flights.
A substantial proportion of patients in our cohort expressed a desire to return to their country of origin. We facilitated successful travel for nearly half of these patients. Our findings identify the need to include travel back to country of origin in the framework of planning care for terminally ill patients.
随着国际移民数量达到前所未有的水平，美国的医生可能会照顾与原籍国有着紧密联系的绝症患者，这类患者可能希望在生命的最后阶段回国。
在本研究中，我们分析了绝症患者将前往原籍国作为护理目标的频率、旅行发生的频率以及与成功旅行相关的因素。
对2005年1月1日至2007年5月1日进行回顾性图表审查。
设置/对象：在美国一个城市安全网卫生系统中，接受姑息治疗咨询服务（包括住院和门诊咨询）的所有外国出生患者。
我们确定患者是否表达了前往原籍国的愿望以及相关因素，包括与旅行相关的人口统计学和功能状态。
在336名外国出生的患者中，129名（38%）表达了前往原籍国的愿望；60名（47%）成功返回24个不同的国家。患者返回人数最多的国家是墨西哥（n = 14）、波兰（n = 11）和菲律宾（n = 7）。尽管功能状态最佳的患者最有可能成功旅行，但16名（31%）功能状态最差（东部肿瘤协作组[ECOG]评分表明只能卧床或坐轮椅）却仍希望旅行的患者也成功出行。途中没有死亡情况，也没有因医疗危机导致航班改道；所有行程均乘坐定期商业航班。
我们队列中的相当一部分患者表达了返回原籍国的愿望。我们帮助近一半的这类患者成功出行。我们的研究结果表明，在为绝症患者制定护理计划的框架中，需要考虑让患者返回原籍国这一因素。
