Exploring the Utilization Patterns Near the End of Life for Children with Cancer
Date Issued
2006
Date
2006
Author(s)
Chen, Yun-Yi
DOI
zh-TW
Abstract
Purpose：
To explore the medical utilization patterns and aggressiveness of care for cancer children at the end of life, and its relationship to factors of demographics, disease and characteristics of medical institution.
Method：
The study was based on claim data from the Bureau of National Health Insurance (BNHI) from 1999 to 2002. There were 691 patients aged 18 and younger with a diagnosis of cancer between 2000 and 2002.
Result：
During the study period, average utilization rate of hospice services was 4.8 percent. After implementing the demonstration project by BNHI for comprehending the integrated care of hospices, study sample who received hospice care increased from 2.5 percent in year 2000 to 6.9 percent in year 2001. Patients with diagnosis of leukemia, living in county, or seeking medical services in areas covered by Central Branch of BNHI were related to fewer utilization rate of hospices.
No matter using hospices or not, more than 30 percent children with cancer experienced admission to acute-care hospitals, intensive care unit, or had emergency department visit in the last month of life. Children who were younger or seeking medical services in areas covered by Northern Branch, Central Branch or Southern Branch, would have risk to experience higher aggressiveness of care compared with Eastern Branch of BNHI.
Conclusion：
In Taiwan, some children with cancer still received aggressive interventions at the end of life. The rate of receiving hospice homecare was low and the whole hospice services had disproportional distribution across the areas and the degree of urbanization. The demonstration project from BNHI for comprehending the integrated care of hospice services enhanced the use of hospice.
Subjects
癌症
兒童
生命末期
照護積極度
安寧緩和醫療
Cancer
Children
End of Life
Aggressiveness of Care
Hospices
Type
thesis
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