Hospice utilization during the SARS outbreak in Taiwan
Hospice utilization during the SARS outbreak in Taiwan
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DOI：
10.1186/1472-6963-6-94
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发表时间：
2006-08-04
影响因子：
2.8
通讯作者：
Hwang, Shinn-Jang
中科院分区：
文献类型：
--
作者：
Chen, Tzeng-Ji;Lin, Ming-Hwai;Hwang, Shinn-Jang
背景：2003年上半年，严重急性呼吸系统综合征（SARS）疫情使世界陷入动荡。随后的许多论文都提到了它对卫生服务利用的影响，但很少有人考虑姑息（临终关怀）护理。本研究的目的是描述在2003年SARS流行期间和之后，在台湾安宁病房住院利用的变化。方法：数据来源是完整的数据集，在2002年和2003年的住院病人从国家健康保险研究数据库。之前和之后的每日和每月的利用率进行了比较。临终关怀分析仅限于这两年提供住院服务的病房。比较扩展到总病床利用率和病人谁仍然承认临终关怀病房在SARS疫情的高峰期。结果：只有15个临终关怀病房整个2002年和2003年。2003年，临终关怀的利用率在4月中旬开始下降，5月25日达到最低点，然后逐渐恢复到前一年11月的水平。临终关怀机构的病床使用率比所有医院病床的使用率下降更明显（例如，2003年5月为-52.5%对-19.9%），恢复速度较慢，滞后三个月。在2003年5月/6月，总共有566名病人住进临终关怀病房，而2002年5月/6月只有818人。性别，年龄和诊断分布没有显着差异。结论：在台湾安宁病房住院病人利用率确实比一般住院病人利用率更敏感的新出现的流行。应确保建立一个具有无缝连续性的均衡网络。
Background: The severe acute respiratory syndrome (SARS) epidemic threw the world into turmoil during the first half of 2003. Many subsequent papers have addressed its impact on health service utilization, but few have considered palliative (hospice) care. The aim of the present study was to describe changes in hospice inpatient utilization during and after the SARS epidemic in 2003 in Taiwan.Methods: The data sources were the complete datasets of inpatient admissions during 2002 and 2003 from the National Health Insurance Research Database. Before-and-after comparisons of daily and monthly utilizations were made. Hospice analyses were limited to those wards that offered inpatient services throughout these two years. The comparisons were extended to total hospital bed utilization and to patients who were still admitted to hospice wards during the peak period of the SARS epidemic.Results: Only 15 hospice wards operated throughout the whole of 2002 and 2003. In 2003, hospice utilization began to decrease in the middle of April, reached a minimum on 25 May, and gradually recovered to the level of the previous November. Hospices showed a more marked reduction in utilization than all hospital beds (e.g. -52.5% vs. -19.9% in May 2003) and a slower recovery with a three-month lag. In total, 566 patients were admitted to hospice wards in May/June 2003, in contrast to 818 in May/June 2002. Gender, age and diagnosis distributions did not differ.Conclusion: Hospice inpatient utilization in Taiwan was indeed more sensitive to the emerging epidemic than general inpatient utilization. A well-balanced network with seamless continuity of care should be ensured.