Fainsinger R L, Bruera E, MacMillan K
Department of Oncology, University of Alberta, Edmonton.
Can Fam Physician. 1997 Nov;43:1983-6, 1989-92.
Access to palliative care in Edmonton has been hampered by uneven development, poor distribution of services, and more recently, economic restraints. Family physicians' involvement in palliative care has been hindered by the variety of access points, poor coordination, and inadequate reimbursement for time-consuming and difficult patient care situations.
To provide high-quality palliative care throughout Edmonton in all settings, with patients able to move easily throughout the components of the program; to lower costs by having fewer palliative care patients die in acute care facilities; and to ensure that family physicians receive support to care for most patients at home or in palliative care units.
The program includes a regional office, home care, and consultant teams. A specialized 14-bed palliative care unit provides acute care. Family physicians are the primary caregivers in the 56 palliative continuing care unit beds.
This program appears to meet most of the need for palliative care in Edmonton. Family physicians, with support from consulting teams, have a central role. Evaluation is ongoing; an important issue is how best to support patients dying at home.
埃德蒙顿的姑息治疗服务受到发展不均衡、服务分布不佳以及近期经济限制的阻碍。家庭医生参与姑息治疗受到多种接入点、协调不善以及对耗时且困难的患者护理情况报销不足的影响。
在埃德蒙顿的所有环境中提供高质量的姑息治疗，使患者能够在项目各组成部分之间轻松转移；通过减少姑息治疗患者在急性护理设施中的死亡人数来降低成本；并确保家庭医生在患者在家或在姑息治疗病房时得到支持以照顾大多数患者。
该项目包括一个地区办公室、家庭护理和顾问团队。一个拥有14张床位的专门姑息治疗病房提供急性护理。家庭医生是56张姑息持续护理病房床位的主要护理人员。
该项目似乎满足了埃德蒙顿大部分的姑息治疗需求。家庭医生在顾问团队的支持下发挥核心作用。评估正在进行；一个重要问题是如何最好地支持在家中死亡的患者。
