台湾地区终末期癌症和非癌症患者姑息性居家护理质量指标的趋势分析：一项 6 年观察性研究。

Trend analysis of quality indicators in palliative home care among terminally ill cancer and non-cancer patients in Taiwan: a 6-year observational study.

机构信息

Department of Medical Education, Taichung Veterans General Hospital, Taichung, Taiwan.

Department of Family Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan, 40705.

出版信息

Support Care Cancer. 2024 Jan 3;32(1):75. doi: 10.1007/s00520-023-08277-2.

DOI:10.1007/s00520-023-08277-2

PMID:38170324

Abstract

PURPOSE

Palliative home care services (PHCS) have been emerging for years. However, limited data exist regarding quality indicators for pain control, unplanned hospital readmissions, and household deaths among terminal cancer and non-cancer patients receiving PHCS.

METHODS

We conducted a retrospective collection and recording of data from 1242 terminally ill cancer and non-cancer patients receiving PHCS. The data were obtained from the Hospice-Palliative Clinical Database (HPCD) of Taichung Veterans General Hospital (TCVGH) for the period from 2016 to 2021. T test and chi-square test were applied for characteristics and the quality indicators among cancer and non-cancer groups. Chi-square test was used for trend analysis of the number of patients receiving PHCS and the quality indicators among cancer and non-cancer groups throughout the study period.

RESULTS

A total of 1242 terminally ill cancer and non-cancer patients who had received PHCS were documented by TCVGH from the years 2016 to 2021, including 221 non-cancer patients and 1021 cancer patients having an average age of 70. The number of terminally ill cancer and non-cancer patients receiving PHCS has increased annually since 2016. Another finding was that age was a statistically significant factor impacting quality indicators. On the other hand, compared to non-cancer patients, cancer patients had a higher likelihood of receiving treatment with analgesics when needed. Their odds of needing analgesics more than three times within 4 days after PHCS enrollment were significantly elevated [OR 4.188, 95% CI (1.002, 17.51)].

CONCLUSION

The results of this 6-year observational study indicate a substantial increase in the number of terminal cancer and non-cancer patients receiving PHCS over the past decade. Furthermore, aging plays an important role in life quality of terminal cancer and non-cancer patients.

摘要

目的

姑息治疗居家护理服务（PHCS）已经出现多年。然而，关于接受 PHCS 的终末期癌症和非癌症患者的疼痛控制、非计划性住院再入院和家庭死亡的质量指标的数据有限。

方法

我们对来自台中荣民总医院（TCVGH）缓和医疗临床资料库（HPCD）的 1242 名接受 PHCS 的终末期癌症和非癌症患者的资料进行了回顾性收集和记录。该资料库涵盖了 2016 年至 2021 年期间的数据。采用 t 检验和卡方检验比较癌症和非癌症组患者的特征和质量指标。采用卡方检验对研究期间癌症和非癌症组患者接受 PHCS 的数量和质量指标进行趋势分析。

结果

TCVGH 从 2016 年至 2021 年共记录了 1242 名接受 PHCS 的终末期癌症和非癌症患者，包括 221 名非癌症患者和 1021 名癌症患者，平均年龄为 70 岁。自 2016 年以来，每年接受姑息治疗居家护理服务的终末期癌症和非癌症患者数量均有所增加。另一个发现是，年龄是影响质量指标的一个具有统计学意义的因素。另一方面，与非癌症患者相比，癌症患者在需要时更有可能接受镇痛治疗。他们在接受 PHCS 登记后 4 天内需要镇痛治疗超过三次的可能性显著增加[比值比 4.188，95%可信区间（1.002，17.51）]。