Factors related to the decision for the place of care among terminal cancer patients after consultation with palliative care team

Abstract

Purpose: Utilization of hospice palliative care (HPC) is promoted by national policy in Korea. However, few studies have sought to identify patterns of HPC utilization among terminal cancer patients. We aimed to investigate patterns of deciding on a place of care for terminal cancer patients and factors related therewith after consultation with a palliative care team (PCT). Materials and methods: We reviewed medical records for 1,028 terminal cancer patients who were referred to the PCT of the National Cancer Center in 2010 and 2014. We compared the characteristics of the patients who decided to utilize HPC units (HPCUs) and those who did not. We also analyzed factors influencing choices for a medical institution and reasons for not selecting an HPCU. Results: The patients’ mean age was 61.0±12.2, with lung cancer patients (24.3%) comprising the largest percentage of these patients. The percentage of referred patients who utilized an HPCU was 53.9% in 2014, increasing from 44.6% in 2010. Older age and awareness of terminal illness were found to be positively associated with utilization of an HPCU. The most common reason for not selecting an HPCU was “refusing hospice” (34.9%), followed by being “near death,” “poor accessibility to an HPCU,” and “caregiving problems.” Conclusion: Compared to 2010, HPC utilization by terminal cancer patients in Korea increased in 2014. Earlier discussion of end-of-life care with patients and family caregivers may help further promote utilization of HPCUs.