RT Journal Article
SR Electronic
T1 Integrated palliative medicine in public oncology: a 10-year review
JF BMJ Supportive & Palliative Care
JO BMJ Support Palliat Care
FD British Medical Journal Publishing Group
SP bmjspcare-2021-002922
DO 10.1136/bmjspcare-2021-002922
A1 Sik Kwan Chan
A1 Tai Chung Lam
A1 Horace Cheuk-Wai Choi
A1 Ka Chun Tsang
A1 Kwok-Keung Yuen
A1 Inda Soong
A1 Kam Hung Wong
A1 Louisa Lui
A1 Sing Hung Lo
A1 Macy Tong
A1 Raymond Lo
A1 Po Tin Lam
A1 Wai Man Lam
A1 Bryan Li
YR 2021
UL http://spcare.bmj.com/content/early/2021/06/29/bmjspcare-2021-002922.abstract
AB Objectives The rapid ageing population of Hong Kong has a high demand on oncology and palliative care (PC) service. This study was the first territory-wide assessment in Hong Kong to assess the palliative service coverage in patients with advanced cancer in the past decade.Methods Cancer deaths of all 43 public hospitals of Hong Kong were screened. Randomly selected 2800 cancer deaths formed a representative cohort in all seven service clusters of Hospital Authority at 4 time points (2006, 2009, 2012, 2015). Individual patient records were thoroughly reviewed. Predictors of PC coverage was evaluated in univariable and multivariable analyses.Results From 2006 to 2015, PC coverage improved steadily from 55.4% to 68.9% (p<0.001). Median time of referral to PC service to death was 25 days (IQR: 53). For duration of inpatient PC, the median time was 22 days (IQR: 44) and it was stable over the past 10 years. Median time of referral to outpatient service to death was 74 days (IQR: 144) and there was an improvement observed (p<0.05). The current system was highly heterogeneous that PC varied between 9.8% and 84.8% in different hospitals depending on the PC service infrastructure. Multivariable Cox model identified patients associated with lower PC coverage: male, <50, rapid disease deterioration and staying in hospitals without multidisciplinary team clinic and designated palliative bed support (all p<0.01).Conclusion There was concrete achievement in palliative service development in the past decade. Heterogeneity and late service provision should be addressed in future.No data are available. Not available since national legislation and the terms of study ethics approval do not allow dataset sharing outside of the institutions participating in the analysis.