Hunt R, McCaul K
Southern Community Hospice Programme, South Australia.
Palliat Med. 1996 Jan;10(1):5-12. doi: 10.1177/026921639601000103.
The aims were to determine the proportion of terminal cancer patients in South Australia who had involvement with a programme of hospice care, to identify the predictors of hospice involvement, and to consider the influence of hospice services, along with other variables, on the place of death. A file of patients of the State's hospice services who died in 1990 was compiled and linked to the population-based Central Cancer Register. We found that 1561 (56%) of the 2800 cancer patients who died in 1990 had care from a hospice service. Patients were less likely to be involved with a hospice service if they were 80 years or older, lived in a rural region, or had a haematological malignancy, and more likely to have hospice care if they had a survival time of more than six months, or were born in the UK or Europe. Patients of hospice services were more likely than other patients to die at home or in an inpatient hospice, and less likely to die in a nursing home or private hospital. A range of other factors were also found to be associated with place of death. We conclude that there has been a rapid acceptance of hospice care in South Australia, with a majority of the target population of cancer patients covered by services. Epidemiological research methods are useful for identifying gaps in the provision of care, and for determining the impact of various factors on where people die. This research is, therefore, important for the formulation and evaluation of policy for the delivery of terminal care.
研究目的是确定南澳大利亚州晚期癌症患者中接受临终关怀项目的比例，找出临终关怀参与情况的预测因素，并考量临终关怀服务以及其他变量对死亡地点的影响。编制了该州1990年去世的临终关怀服务患者档案，并将其与基于人群的中央癌症登记处相链接。我们发现，1990年去世的2800名癌症患者中有1561名（56%）接受了临终关怀服务。80岁及以上、居住在农村地区或患有血液系统恶性肿瘤的患者接受临终关怀服务的可能性较小；存活时间超过6个月、出生在英国或欧洲的患者接受临终关怀服务的可能性较大。接受临终关怀服务的患者比其他患者更有可能在家中或住院临终关怀机构死亡，而在养老院或私立医院死亡的可能性较小。还发现一系列其他因素与死亡地点有关。我们得出结论，南澳大利亚州对临终关怀服务的接受程度迅速提高，大多数癌症患者这一目标人群都得到了服务覆盖。流行病学研究方法有助于找出护理提供方面的差距，并确定各种因素对人们死亡地点的影响。因此，这项研究对于制定和评估临终护理政策很重要。
