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Late referral to palliative care services in Korea

Authors
 Young Ji Baek  ;  Dong Wook Shin  ;  Jin Young Choi  ;  Jina Kang  ;  Ha Na Mo  ;  Yang Hyeok Kim  ;  Sohee Kim  ;  Kyu Won Jung  ;  Jisoo Joo  ;  Eun-Cheol Park 
Citation
 JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, Vol.41(4) : 692-699, 2011 
Journal Title
 JOURNAL OF PAIN AND SYMPTOM MANAGEMENT 
ISSN
 0885-3924 
Issue Date
2011
MeSH
Adolescent ; Adult ; Aged ; Female ; Humans ; Insurance, Health ; Karnofsky Performance Status ; Male ; Middle Aged ; Neoplasms/complications ; Palliative Care/statistics & numerical data* ; Proportional Hazards Models ; Quality of Life ; Referral and Consultation/statistics & numerical data* ; Religion ; Republic of Korea/epidemiology ; Stress, Psychological/prevention & control ; Survival ; Young Adult
Keywords
Length of stay ; survival ; palliative care ; Korea ; referral
Abstract
CONTEXT: Although timely referral to palliative care services can help improve quality of life by minimizing patient and family suffering during a life-threatening illness, it remains unclear whether patients in Korea who suffer from advanced cancer are referred to palliative care services in a timely manner. OBJECTIVES: We aimed to investigate the timeliness of patient referral to palliative care services in Korea by examining the duration of survival after enrollment and identify the factors contributing to earlier or later referral. METHODS: Patient- and episode-level data were collected from 3867 terminal cancer patients, who were registered in 34 inpatient palliative care services designated by the Ministry of Health, Welfare, and Family Affairs. Cox proportional hazard models were used to determine factors associated with the duration of survival after enrollment in palliative care services. RESULTS: The median duration of survival after enrollment in palliative care services was 18 days. Male sex, liver cancer diagnosis, poor performance status, being covered by National Health Insurance, and being married were significantly associated with shorter duration of survival after enrollment, whereas a prostate cancer diagnosis was associated with longer survival. CONCLUSION: Korean terminal cancer patients are referred to palliative care very late, and the timing appears to be influenced by some socioeconomic and medical factors. Interventions, such as physician education and establishing palliative care teams, are required to promote earlier referrals in Korea.
Full Text
http://www.sciencedirect.com/science/article/pii/S0885392410010201
DOI
10.1016/j.jpainsymman.2010.06.019
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/95474
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