Ueng Ruey-Shiuan, Hsu Su-Hsuan, Shih Chih-Yuan, Huang Sheng-Jean
Department of Nursing, National Taiwan University Hospital Jin-Shan Branch, Taiwan, ROC.
Department of Family Medicine, National Taiwan University Hospital Jin-Shan Branch, Taiwan, ROC.
Hu Li Za Zhi. 2015 Apr;62(2):18-24. doi: 10.6224/JN.62.2.18.
In Taiwan, the Department of Health (DOH) has implemented regulations and policies related to hospice and palliative care since 1995. Taiwan is the first country in Asia to have a Natural Death Act, promulgated in 2000. Although recognition of the need for palliative care in non-cancer terminally ill patients is increasing, at present, the needs of these patients are often not met. Moreover, while a majority of the population prefers to die at home, the percentage of patients who die in the home setting remains small. The palliative care system should be adjusted to improve the accessibility and continuity of care based on the needs of patients. Therefore, the Jin-Shan Branch of the National Taiwan University Hospital has run a pilot community palliative care service model since 2012. National Health Insurance reimbursement was introduced in 2014 for community-based palliative care services. Establishing a formal system of community-based palliative care should be encouraged in order to improve the quality of care at the end of life and to allow more patients to receive end-of-life care and die in their own communities. This system will require that skilled nurses provide discharge planning, symptoms control, end-of-life communications, social-resources integration, and social-support networks in order to achieve a high quality of end-of-life care.
在台湾，卫生署自1995年起就实施了与临终关怀及缓和医疗相关的法规和政策。台湾是亚洲第一个在2000年颁布《自然死亡法》的地区。尽管对非癌症晚期患者的缓和医疗需求的认可度在不断提高，但目前这些患者的需求往往得不到满足。此外，虽然大多数人希望在家中离世，但在家中死亡的患者比例仍然很小。缓和医疗体系应根据患者需求进行调整，以提高医疗服务的可及性和连续性。因此，台湾大学医院金山分院自2012年起开展了社区缓和医疗服务试点模式。2014年开始对社区缓和医疗服务实行全民健康保险报销。应鼓励建立正式的社区缓和医疗体系，以提高临终关怀质量，让更多患者在自己的社区接受临终关怀并离世。该体系将要求专业护士提供出院计划、症状控制、临终沟通、社会资源整合及社会支持网络，以实现高质量的临终关怀。
