Integration of Specialist Palliative Care into Tertiary Hospitals: A Multicenter Point Prevalence Survey from Thailand

被引:9
作者
Pairojkul, Srivieng [1 ,2 ]
Thongkhamcharoen, Rojanasak [3 ]
Raksasataya, Attakorn [1 ]
Sorasit, Chalermsri [1 ]
Nakawiro, Pakkawee [4 ]
Sudsa, Supannee [5 ]
Sattamai, Chaleow [6 ]
Puripanpinyo, Napassawan [7 ]
Oerareemitr, Nittha [8 ]
Raksadaen, Boriboon [9 ]
Apaijitt, Patthamaporn [10 ]
Santisant, Busaya [11 ]
Thammachote, Pruksaporn [12 ]
Thunyawan, Sermsuk [13 ]
Rattanachun, Valika [14 ]
Fagcharoenpol, Vittawin [15 ]
机构
[1] Khon Kaen Univ, Fac Med, Karunruk Palliat Care Ctr, Khon Kaen, Thailand
[2] Thai Palliat Care Soc, Khon Kaen, Thailand
[3] Maesot Gen Hosp, Dept Social Med, Tak, Thailand
[4] Phra Nakhon Si Ayutthaya Reg Hosp, Dept Social Med, Phra Nakhon Si Ayutthaya, Thailand
[5] Udonthani Reg Hosp, Dept Med, Udonthani, Thailand
[6] Surin Reg Hosp, Dept Palliat Care & Long Term Care, Surin, Thailand
[7] Roi Et Reg Hosp, Dept Social Med, Roi Et, Thailand
[8] Phramongkutklao Hosp, Fac Med, Dept Pulm & Crit Care Med, Bangkok, Thailand
[9] Buddhachinaraj Reg Hosp, Dept Social Med, Phitsanulok, Thailand
[10] Nangrong Gen Hosp, Dept Nursing, Buriram, Thailand
[11] Vachira Phuket Reg Hosp, Jairak Palliat Care Ctr, Phuket, Thailand
[12] Songkhla Gen Hosp, Dept Social Med, Songkhla, Thailand
[13] Loei Gen Hosp, Dept Nursing, Loei, Thailand
[14] Nan Gen Hosp, Dept Social Med, Nan, Thailand
[15] Buriram Reg Hosp, Dept Social Med, Buriram, Thailand
来源
PALLIATIVE MEDICINE REPORTS | 2021年 / 2卷 / 01期
关键词
accessibility; advance care planning; palliative care specialist; prevalence; strong opioids prescription; Thailand; NATIONAL-SURVEY; INPATIENTS; ATTITUDES; NEED;
D O I
10.1089/pmr.2021.0003
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: Accessibility and quality of hospital-based palliative care in Thailand have received scant attention. Objective: To determine the prevalence of inpatients who require in-hospital palliative care, to identify the proportion with access to specialist palliative care, and to define the factors associated with accessibility to specialist palliative care. Design: A cross-sectional analysis of a multicenter survey. Setting/Subjects: We surveyed all hospitalized patients from Thailand's four regions admitted to 14 tertiary care hospitals. Measurements: We used the Supportive and Palliative Care Indicators Tool to identify palliative care patients then reviewed their medical records. We categorized hospitalized palliative care patients into a palliative care consultation group and a nonconsultation group. The odds ratio (OR) between patient characteristics and patient groups was estimated using binary logistic regression. Results: One-fifth (18.7%) of hospitalized patients were palliative care patients, whereas only 17.3% received a specialist palliative care consult. Of these, one-third (28.4%) received advance care planning (ACP) documentation. One-quarter of patients in pain were not prescribed analgesics. The logistic regression analysis revealed that palliative care consultations were associated with patients >65 years (OR = 1.830, 95% confidence interval [CI]: 1.122-2.987), a cancer diagnosis (OR = 2.640, 95% CI: 1.478-4.718), strong opioids prescription (OR = 5.519, 95% CI: 3.217-9.469), and ACP documentation (OR = 50.149, 95% CI: 28.239-89.059). Conclusions: The prevalence of hospitalized palliative care patients in Thailand is comparable with that in developed countries; however, accessibility remains a significant gap, as specialist palliative care is associated with the quality of palliative care service.
引用
收藏
页码:272 / 279
页数:8
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