Eunmi Ahn1, In Gyu Song2, Jin Young Choi2, Hyun Jung Jho2, Ilyeon Park2, Suah Sung2, Seohyun Shin2, So Jung Park2, Eun Jung Nam2, Sung Hoon Jeong2, Yoon Jung Chang3. 1. Division of Health Services Development for Persons with Disabilities, Ministry of Health and Welfare National Rehabilitation Center, 58 Samgaksan-ro, GangBuk-gu, Seoul, 01022, South Korea. 2. National Hospice Center, National Cancer Center, 323 Ilsan-ro, Ilsnadong-gu, Goyang-si, Gyeonggi-do, South Korea. 3. National Hospice Center, National Cancer Center, 323 Ilsan-ro, Ilsnadong-gu, Goyang-si, Gyeonggi-do, South Korea. eunicemd@ncc.re.kr.
Abstract
PURPOSE: Many assert the need for home hospice care. However, limited research has shown its effectiveness. The authors of this study thus evaluated the effectiveness of a home hospice care pilot project regarding (1) early enrollment in hospice care, (2) efficient use of inpatient hospice resources, and (3) enabling terminally ill patients to stay at their preferred place of care. METHODS: The authors conducted a nationwide prospective observational study. Patients were divided into home hospice care users (ever-users, n = 902) and inpatient-only hospice care users (never-users, n = 8210). Information about hospice service utilization was collected from a web-based registry system. Patients were registered if they started to receive the hospice service after providing written informed consent during the pilot project from March 2016-July 2017. RESULTS: Most ever-users preferred to stay at home (84.0%), while never-users preferred hospital admission (66.9%). Most ever-users were enrolled in hospice by home care (78.9%) and used both home and inpatient care (72.4%). The overall duration of hospice care was significantly longer among ever-users than never-users (median 39 vs. 15 days, respectively; mean ± SD 59.6 ± 62.8 vs. 24.8 ± 32.1, respectively; p < .001). Participation in the pilot program improved bed utilization (p = .025) and turnover rate (p < .001) of inpatient hospice service. CONCLUSIONS: Home hospice care enabled early enrollment in hospice services and provided a valid option to patients who wished to stay at home. Policy efforts to facilitate home hospice care are needed.
PURPOSE: Many assert the need for home hospice care. However, limited research has shown its effectiveness. The authors of this study thus evaluated the effectiveness of a home hospice care pilot project regarding (1) early enrollment in hospice care, (2) efficient use of inpatient hospice resources, and (3) enabling terminally ill patients to stay at their preferred place of care. METHODS: The authors conducted a nationwide prospective observational study. Patients were divided into home hospice care users (ever-users, n = 902) and inpatient-only hospice care users (never-users, n = 8210). Information about hospice service utilization was collected from a web-based registry system. Patients were registered if they started to receive the hospice service after providing written informed consent during the pilot project from March 2016-July 2017. RESULTS: Most ever-users preferred to stay at home (84.0%), while never-users preferred hospital admission (66.9%). Most ever-users were enrolled in hospice by home care (78.9%) and used both home and inpatient care (72.4%). The overall duration of hospice care was significantly longer among ever-users than never-users (median 39 vs. 15 days, respectively; mean ± SD 59.6 ± 62.8 vs. 24.8 ± 32.1, respectively; p < .001). Participation in the pilot program improved bed utilization (p = .025) and turnover rate (p < .001) of inpatient hospice service. CONCLUSIONS: Home hospice care enabled early enrollment in hospice services and provided a valid option to patients who wished to stay at home. Policy efforts to facilitate home hospice care are needed.
Entities:
Keywords:
Cancer; Effectiveness; Home care; Hospice care; Palliative care; Utilization
Authors: Young-Taek Park; Daekyun Kim; Su-Jin Koh; Yeon Sook Kim; Sang Mi Kim Journal: Int J Environ Res Public Health Date: 2022-01-29 Impact factor: 3.390