Availability of Services in Ontario Hospices and Hospitals Providing Inpatient Palliative Care

被引:15
作者
Towns, Kathryn [2 ]
Dougherty, Elizabeth
Kevork, Nanor
Wiljer, David [5 ]
Seccareccia, Dori [3 ]
Rodin, Gary [4 ,7 ]
Le, Lisa W. [6 ]
Zimmermann, Camilla [1 ,2 ,3 ,4 ,7 ]
机构
[1] Princess Margaret Hosp, Palliat Care Program, Dept Psychosocial Oncol & Palliat Care, Univ Hlth Network, Toronto, ON M5G 2M9, Canada
[2] Univ Toronto, Div Med Oncol & Hematol, Dept Med, Toronto, ON M5S 1A1, Canada
[3] Univ Toronto, Div Palliat Care, Dept Family & Community Med, Toronto, ON M5S 1A1, Canada
[4] Univ Toronto, Dept Psychiat, Toronto, ON M5S 1A1, Canada
[5] Princess Margaret Hosp, Oncol Educ Radiat Med Program, Univ Hlth Network, Toronto, ON M5G 2M9, Canada
[6] Princess Margaret Hosp, Dept Biostat, Univ Hlth Network, Toronto, ON M5G 2M9, Canada
[7] Princess Margaret Hosp, Ontario Canc Inst, Univ Hlth Network, Toronto, ON M5G 2M9, Canada
关键词
LONG-TERM-CARE; OF-LIFE CARE; MANAGEMENT; DYSPNEA; LUNG;
D O I
10.1089/jpm.2011.0453
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
Purpose: Most Canadians die in inpatient settings. Our aim was to determine the availability of medical services, programs, and care for common palliative procedures, in hospices, palliative care units (PCUs), and hospital medical wards (MWs) providing inpatient palliative care in Ontario, Canada. Methods: We identified facilities providing inpatient palliative care using the Ontario Hospital Association (OHA) and Hospice Association of Ontario (HAO) websites. An electronic survey was sent to the person responsible for palliative care at each facility. We compared services available among the three types of units, using Fisher's exact and Kruskal-Wallis tests. Results: Of 128 surveys sent, 102 (80%) were completed and returned, from 58 MWs, 31 PCUs, and 13 hospices. MWs were the most common location of palliative care overall, particularly in rural areas. PCUs were most likely to provide care for common procedures (e. g., tracheostomy, nephrostomy; p < 0.01); methadone for pain management (p < 0.0001); and palliative radiation (p < 0.01). MWs were most likely to offer intravenous chemotherapy and antibiotics (p < 0.01). Transfusions were available in most PCUs and MWs, but only in one hospice (p < 0.0001). Hospices were most likely to provide complementary therapies. Lack of financial support and human resources were the most frequent perceived barriers to providing quality palliative care. Conclusions: There is considerable variability of available services depending on the setting where inpatient palliative care is provided. Further financial support and resources are required to ensure consistent high quality of care in both urban and rural areas.
引用
收藏
页码:527 / 534
页数:8
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