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Article: Advance directive and preference of old age home residents for community model of end-of-life care in Hong Kong
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TitleAdvance directive and preference of old age home residents for community model of end-of-life care in Hong Kong
 
AuthorsChu, LW
McGhee, SM
Luk, JKH
Kwok, T
Hui, E
Chiu, PKC
Lee, DTF
Woo, J
 
Issue Date2011
 
CitationHong Kong Medical Journal, 2011, v. 17 n. 3, Suppl 3, p. 13-15 [How to Cite?]
 
AbstractKey Messages: 1. Among 1600 cognitively normal elderly persons living in old age homes in Hong Kong, 88% preferred palliative treatments that could keep them comfortable and free from pain, and 88% agreed to have advance directives. Factors that favour having advance directives among Chinese elders included the practice of asking for relatives’ advice in medical decisions, wishing to be informed of their terminal illness diagnoses, absence of a stroke history, and having no problems in self-care. 2. Approximately one third of old age home residents would accept dying in place. Older age, religion (Catholic or non-believer of traditional Chinese religion), having a better mood score (Geriatric Depression Scale), having no siblings, not receiving an old age allowance, and being a resident of subvented old age homes were independent predictors of preference for community end-of-life care and dying in place. 3. End-of-life care in the hospital was expensive. The total bed-day costs for the 2084 deaths in the two clusters for the index death episode, cumulative 3, 6, and 12 months of hospitalisation were HK$65 474 591, HK$82 543 510, HK$100 170 949, and HK$108 960 348, respectively. The annual cost-savings in hospitalisation bed-days would be HK$177 million when about 30% of elders accepted dying in their old age homes. 4. Elderly residents were willing to pay an additional fee for community end-of-life care services in old age homes. Both the services of the doctor and old age home staff were important attributes. Hence, elderly people were prepared to use more community end-of-life care if better staff and doctor services were provided.
 
DescriptionAuthor Chinese names: 朱亮榮, 麥潔儀, 駱駱虹, 郭志銳, 許鷗思, 李德誠, 李子芬, 胡令芳
 
DC FieldValue
dc.contributor.authorChu, LW
 
dc.contributor.authorMcGhee, SM
 
dc.contributor.authorLuk, JKH
 
dc.contributor.authorKwok, T
 
dc.contributor.authorHui, E
 
dc.contributor.authorChiu, PKC
 
dc.contributor.authorLee, DTF
 
dc.contributor.authorWoo, J
 
dc.date.accessioned2011-08-26T14:29:01Z
 
dc.date.available2011-08-26T14:29:01Z
 
dc.date.issued2011
 
dc.description.abstractKey Messages: 1. Among 1600 cognitively normal elderly persons living in old age homes in Hong Kong, 88% preferred palliative treatments that could keep them comfortable and free from pain, and 88% agreed to have advance directives. Factors that favour having advance directives among Chinese elders included the practice of asking for relatives’ advice in medical decisions, wishing to be informed of their terminal illness diagnoses, absence of a stroke history, and having no problems in self-care. 2. Approximately one third of old age home residents would accept dying in place. Older age, religion (Catholic or non-believer of traditional Chinese religion), having a better mood score (Geriatric Depression Scale), having no siblings, not receiving an old age allowance, and being a resident of subvented old age homes were independent predictors of preference for community end-of-life care and dying in place. 3. End-of-life care in the hospital was expensive. The total bed-day costs for the 2084 deaths in the two clusters for the index death episode, cumulative 3, 6, and 12 months of hospitalisation were HK$65 474 591, HK$82 543 510, HK$100 170 949, and HK$108 960 348, respectively. The annual cost-savings in hospitalisation bed-days would be HK$177 million when about 30% of elders accepted dying in their old age homes. 4. Elderly residents were willing to pay an additional fee for community end-of-life care services in old age homes. Both the services of the doctor and old age home staff were important attributes. Hence, elderly people were prepared to use more community end-of-life care if better staff and doctor services were provided.
 
dc.description.naturepublished_or_final_version
 
dc.descriptionAuthor Chinese names: 朱亮榮, 麥潔儀, 駱駱虹, 郭志銳, 許鷗思, 李德誠, 李子芬, 胡令芳
 
dc.identifier.citationHong Kong Medical Journal, 2011, v. 17 n. 3, Suppl 3, p. 13-15 [How to Cite?]
 
dc.identifier.epage15
 
dc.identifier.hkuros189171
 
dc.identifier.issue3, Suppl 3
 
dc.identifier.spage13
 
dc.identifier.urihttp://hdl.handle.net/10722/137608
 
dc.identifier.volume17
 
dc.languageeng
 
dc.relation.ispartofHong Kong Medical Journal
 
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License
 
dc.titleAdvance directive and preference of old age home residents for community model of end-of-life care in Hong Kong
 
dc.typeArticle
 
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<item><contributor.author>Chu, LW</contributor.author>
<contributor.author>McGhee, SM</contributor.author>
<contributor.author>Luk, JKH</contributor.author>
<contributor.author>Kwok, T</contributor.author>
<contributor.author>Hui, E</contributor.author>
<contributor.author>Chiu, PKC</contributor.author>
<contributor.author>Lee, DTF</contributor.author>
<contributor.author>Woo, J</contributor.author>
<date.accessioned>2011-08-26T14:29:01Z</date.accessioned>
<date.available>2011-08-26T14:29:01Z</date.available>
<date.issued>2011</date.issued>
<identifier.citation>Hong Kong Medical Journal, 2011, v. 17 n. 3, Suppl 3, p. 13-15</identifier.citation>
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<description.abstract>Key Messages: 
1. Among 1600 cognitively normal elderly persons living in old age homes in Hong Kong, 88% preferred palliative treatments that could keep them comfortable and free from pain, and 88% agreed to have advance directives. Factors that favour having advance directives among Chinese elders included the practice of asking for relatives&#8217; advice in medical decisions, wishing to be informed of their terminal illness diagnoses, absence of a stroke history, and having no problems in self-care.
2. Approximately one third of old age home residents would accept dying in place. Older age, religion (Catholic or non-believer of traditional Chinese religion), having a better mood score (Geriatric Depression Scale), having no siblings, not receiving an old age allowance, and being a resident of subvented old age homes were independent predictors of preference for community end-of-life care and dying in place.
3. End-of-life care in the hospital was expensive. The total bed-day costs for the 2084 deaths in the two clusters for the index death episode, cumulative 3, 6, and 12 months of hospitalisation were HK$65 474 591, HK$82 543 510, HK$100 170 949, and HK$108 960 348, respectively. The annual cost-savings in hospitalisation bed-days would be HK$177 million when about 30% of elders accepted dying in their old age homes.
4. Elderly residents were willing to pay an additional fee for community end-of-life care services in old age homes. Both the services of the doctor and old age home staff were important attributes. Hence, elderly people were prepared to use more community end-of-life care if better staff and doctor services were provided.</description.abstract>
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