台北榮民總醫院大德病房五年住院病患分析

A Five-Year Analysis of the Inpatient Service of the Hospice and Palliative Care Unit in VGH-Taipei

10.7023/TJFM.200509.0123

邱金德(Jin-Der Chiou)；陳健文(Chien-Wen Chen)；林明慧(Ming-Hwai Lin)；吳彬源(Pin-Yuan Wu)；劉瑞瑤(Jui-Yao Liu)；陳曾基(Tzeng-Ji Chen)；陳振文(Tzen-Wen Chen)；黃信彰(Shinn-Jang Hwang)；蔡世滋(Shih-Tzu Tsai)

inpatient hospice care ； palliative care

台灣家庭醫學雜誌

15卷3期（2005 / 09 / 01）

123 - 133

繁體中文

Since the establishment of the Dah-Der hospice palliative unit in the Veterans General Hospital-Taipei in July 1997, a total of 1,533 admissions were recorded with a computerized database until July 2002. We analyzed the data and compared the before and after implementaion of the ”pilot project on Per-diem payment for inpatient hospice services of Taiwan's National Health Insurance program” (PDP) to see if there were any differences. The results: the patients were mostly male (65.6%), with a mean of 67.4 years old (standard error 13.9, SE). The source of the patients was mostly referred from within the hospital (58.1%). The most common diagnoses were lung cancer, colon-rectal cancer, and gastric cancer. The average duration of the inpatient service time is 16.1 (±15.2, ±SD) days. Those patients discharged due to death or dying had an average duration of 14.2 (±14.6) days, whereas others discharged under stable condition had 21.9 (±15.5) days; there was a statistically significant difference between these two groups. 38% of known expired patients had received hospice palliative care for less than 7 days (late referral). After the implementation of the PDP, the average duration of hospital stay decreased from 17.5 (±16.4) to 14.5 (±13.5) days (P＜0.001). This increased the turn-over rate of the beds, and allowed the dying patients to be admitted to the Dah-Der ward. This means more families can have the opportunity of receiving holistic care and proper bereavement support.

Since the establishment of the Dah-Der hospice palliative unit in the Veterans General Hospital-Taipei in July 1997, a total of 1,533 admissions were recorded with a computerized database until July 2002. We analyzed the data and compared the before and after implementaion of the ”pilot project on Per-diem payment for inpatient hospice services of Taiwan's National Health Insurance program” (PDP) to see if there were any differences. The results: the patients were mostly male (65.6%), with a mean of 67.4 years old (standard error 13.9, SE). The source of the patients was mostly referred from within the hospital (58.1%). The most common diagnoses were lung cancer, colon-rectal cancer, and gastric cancer. The average duration of the inpatient service time is 16.1 (±15.2, ±SD) days. Those patients discharged due to death or dying had an average duration of 14.2 (±14.6) days, whereas others discharged under stable condition had 21.9 (±15.5) days; there was a statistically significant difference between these two groups. 38% of known expired patients had received hospice palliative care for less than 7 days (late referral). After the implementation of the PDP, the average duration of hospital stay decreased from 17.5 (±16.4) to 14.5 (±13.5) days (P＜0.001). This increased the turn-over rate of the beds, and allowed the dying patients to be admitted to the Dah-Der ward. This means more families can have the opportunity of receiving holistic care and proper bereavement support.

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