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Article: Quality of Care for Older Patients with Non-Cancer Diagnoses under the End-of-Life Care Program

TitleQuality of Care for Older Patients with Non-Cancer Diagnoses under the End-of-Life Care Program
Authors
Issue Date2016
PublisherOpenventio Publishers. The Journal's web site is located at http://openventio.org/OpenJournal/PalliativeMedicineandHospiceCare.html
Citation
Palliative Medicine and Hospice Care - Open Journal, 2016, v. 2, p. 7-13 How to Cite?
AbstractBackground: End-of-life (EOL) care is an important part of geriatric medicine in view of rapidly ageing populations in the world. Aim: We aimed to evaluate the quality of care for older patients with non-cancer terminal illnesses, who died in 2010, under the EOL care program of an academic medical unit in Hong Kong. This unit consisted of an acute hospital, Prince of Wales Hospital (PWH) and a convalescence hospital (Shatin Hospital, SH). Methods: This was a retrospective hospital-based audit of clinical effectiveness of the EOL service. We reviewed the quality of patient care during the final seven days of life. The quality of care was evaluated based on the compliance rates of five selected goals and the adoption of futile life-sustaining procedures and treatments. Results: Case records of 129 patients in the EOL care program were analyzed. Two goals, including minimization of regular monitoring of vital signs and no blood taking, achieved over 70% compliance at SH and 0% at PWH. The compliance rates of discontinuation of non-essential medications were 46.4% in SH and 47.1% in PWH; and the compliance rates of switching essential medications to non-oral routes were 63.4% in SH and 70.6% in PWH (not statistically significant). The compliance rates of using as-required intravenous or subcutaneous medications were extremely low (<2%) at both hospitals. All futile life-sustaining procedures and treatments were initiated at the PWH. Conclusions: We demonstrated significant differences in the quality of EOL care between the acute hospital and convalescence hospital. Greater emphasis on specialist training and education with allocation of resources may improve the EOL care in both settings.
Persistent Identifierhttp://hdl.handle.net/10722/232073
ISSN

 

DC FieldValueLanguage
dc.contributor.authorTang, WH-
dc.contributor.authorMa, HM-
dc.contributor.authorLee, JSW-
dc.contributor.authorHui, E-
dc.contributor.authorWoo, J-
dc.contributor.authorKwan, SKJ-
dc.date.accessioned2016-09-20T05:27:31Z-
dc.date.available2016-09-20T05:27:31Z-
dc.date.issued2016-
dc.identifier.citationPalliative Medicine and Hospice Care - Open Journal, 2016, v. 2, p. 7-13-
dc.identifier.issn2377-8393-
dc.identifier.urihttp://hdl.handle.net/10722/232073-
dc.description.abstractBackground: End-of-life (EOL) care is an important part of geriatric medicine in view of rapidly ageing populations in the world. Aim: We aimed to evaluate the quality of care for older patients with non-cancer terminal illnesses, who died in 2010, under the EOL care program of an academic medical unit in Hong Kong. This unit consisted of an acute hospital, Prince of Wales Hospital (PWH) and a convalescence hospital (Shatin Hospital, SH). Methods: This was a retrospective hospital-based audit of clinical effectiveness of the EOL service. We reviewed the quality of patient care during the final seven days of life. The quality of care was evaluated based on the compliance rates of five selected goals and the adoption of futile life-sustaining procedures and treatments. Results: Case records of 129 patients in the EOL care program were analyzed. Two goals, including minimization of regular monitoring of vital signs and no blood taking, achieved over 70% compliance at SH and 0% at PWH. The compliance rates of discontinuation of non-essential medications were 46.4% in SH and 47.1% in PWH; and the compliance rates of switching essential medications to non-oral routes were 63.4% in SH and 70.6% in PWH (not statistically significant). The compliance rates of using as-required intravenous or subcutaneous medications were extremely low (<2%) at both hospitals. All futile life-sustaining procedures and treatments were initiated at the PWH. Conclusions: We demonstrated significant differences in the quality of EOL care between the acute hospital and convalescence hospital. Greater emphasis on specialist training and education with allocation of resources may improve the EOL care in both settings.-
dc.languageeng-
dc.publisherOpenventio Publishers. The Journal's web site is located at http://openventio.org/OpenJournal/PalliativeMedicineandHospiceCare.html-
dc.relation.ispartofPalliative Medicine and Hospice Care - Open Journal-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleQuality of Care for Older Patients with Non-Cancer Diagnoses under the End-of-Life Care Program-
dc.typeArticle-
dc.identifier.emailKwan, SKJ: jskkwan@hku.hk-
dc.identifier.authorityKwan, SKJ=rp01868-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.17140/PMHCOJ-2-111-
dc.identifier.hkuros266709-
dc.identifier.volume2-
dc.identifier.spage7-
dc.identifier.epage13-
dc.publisher.placeUnited States-

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