Malden L T, Sutherland C, Tattersall M H, Morgan J, Forsyth S, Levi J A, Gunz F W
Med J Aust. 1984 Aug 4;141(3):147-50. doi: 10.5694/j.1326-5377.1984.tb113060.x.
An analysis of factors influencing the place of death of patients seen by two medical oncology units is reported. There were 1295 recorded deaths of patients from the Royal Prince Alfred Hospital, Sydney, and 688 from The Royal North Shore Hospital of Sydney during 1979-1981; the places of death were known in 1724 instances (87%). Of these, 73% of patients died in hospital, 9% died in terminal nursing care (TNC) institutions, and the remainder at home. Factors influencing the place of death were the place of residence, age, home circumstances-social support, diagnosis, and interval from first contact with the medical oncology unit. Our data indicate that a complex interrelation of these factors determines the place of death. Improvements in community services may allow more patients with cancer to die at home or in TNC institutions, but a substantial proportion of these will still die in major hospitals. Therefore, there is a need for the improvement of palliative care services in these institutions.
本文报告了对两个肿瘤内科所诊治患者死亡地点影响因素的分析。1979年至1981年期间，悉尼皇家阿尔弗雷德王子医院有1295例患者死亡记录，悉尼皇家北岸医院有688例；已知死亡地点的有1724例（87%）。其中，73%的患者在医院死亡，9%在临终护理（TNC）机构死亡，其余在家中死亡。影响死亡地点的因素包括居住地点、年龄、家庭环境 - 社会支持、诊断以及从首次接触肿瘤内科起的时间间隔。我们的数据表明，这些因素之间存在复杂的相互关系，共同决定了死亡地点。社区服务的改善可能会使更多癌症患者在家中或TNC机构死亡，但其中仍有相当一部分会在大型医院死亡。因此，有必要改善这些机构的姑息治疗服务。
