Characteristics of hospice delivery model
| Hospice services no. (%) | |||||
| Characteristic | Overall (N=8874) | HSC (n=7076) | HIC (n=918) | HHC (n=880) | P value* |
| Basic demographics | |||||
| Age, mean (SD), years | 65 (16) | 64 (16) | 67 (14) | 72 (14) | <0.001 |
| Gender | <0.001 | ||||
| Male | 5368 (60.5) | 4358 (61.6) | 525 (57.2) | 485 (55.1) | |
| Female | 3506 (39.5) | 2718 (38.4) | 393 (42.8) | 395 (44.9) | |
| Religious | <0.001 | ||||
| Folk beliefs | 4455 (68.9) | 3344 (69.8) | 506 (59.8) | 605 (73.3) | |
| Buddhism | 685 (10.6) | 415 (8.7) | 147 (17.4) | 123 (14.9) | |
| Christian/Catholicism | 374 (5.8) | 262 (5.5) | 65 (7.7) | 47 (5.7) | |
| Taoism | 760 (11.8) | 629 (13.1) | 98 (11.6) | 33 (4.0) | |
| Other | 188 (2.9) | 141 (2.9) | 30 (3.5) | 17 (2.1) | |
| Patients with cancer | <0.001 | ||||
| No | 1205 (13.6) | 1088 (15.4) | 47 (5.1) | 70 (8.0) | |
| Yes | 7669 (86.4) | 5988 (84.6) | 871 (94.9) | 810 (92.0) | |
| DNR document signing | <0.001 | ||||
| Before care | 4476 (62.3) | 2913 (53.3) | 786 (92.0) | 777 (89.6) | |
| After care | 2710 (37.7) | 2552 (46.7) | 68 (8.0) | 90 (10.4) | |
| ECOG performance | <0.001 | ||||
| 0–2 | 285 (4.7) | 248 (5.7) | 28 (3.2) | 9 (1.0) | |
| 3–4 | 5779 (95.3) | 4080 (94.3) | 845 (96.8) | 854 (99.0) | |
| Symptoms/signs score | |||||
| Pain | <0.001 | ||||
| 0–3 | 5478 (88.3) | 3958 (89.3) | 746 (83.1) | 774 (88.5) | |
| 4–6 | 558 (9.0) | 345 (7.8) | 123 (13.7) | 90 (10.3) | |
| 7–10 | 167 (2.7) | 127 (2.9) | 29 (3.2) | 11 (1.3) | |
| Dyspnoea | <0.001 | ||||
| 0 | 1427 (22.5) | 819 (17.9) | 252 (28.0) | 356 (40.7) | |
| 1–2 | 2619 (41.2) | 2121 (46.3) | 142 (15.8) | 356 (40.7) | |
| 3–4 | 2304 (36.3) | 1637 (35.8) | 505 (56.2) | 162 (18.5) | |
| Nausea | <0.001 | ||||
| 0 | 5011 (82.6) | 3698 (86.0) | 685 (77.1) | 628 (71.7) | |
| 1–2 | 765 (12.6) | 431 (10.0) | 119 (13.4) | 215 (24.5) | |
| 3–4 | 290 (4.8) | 173 (4.0) | 84 (9.5) | 33 (3.8) | |
| Constipation | <0.001 | ||||
| 0 | 2376 (39.1) | 1943 (45.2) | 261 (29.0) | 172 (19.6) | |
| 1–2 | 2572 (42.4) | 1621 (37.7) | 475 (52.8) | 476 (54.3) | |
| 3–4 | 1124 (18.5) | 733 (17.1) | 163 (18.1) | 228 (26.0) | |
| Dysphagia | <0.001 | ||||
| 0 | 1265 (20.7) | 950 (21.8) | 167 (18.6) | 148 (16.9) | |
| 1–2 | 1680 (27.4) | 928 (21.3) | 276 (30.7) | 476 (54.4) | |
| 3–4 | 3178 (51.9) | 2470 (56.8) | 457 (50.8) | 251 (28.7) | |
| Fungating wound | 0.510 | ||||
| 0 | 5586 (93.4) | 3952 (93.6) | 818 (92.7) | 816 (93.2) | |
| 1–2 | 286 (4.8) | 191 (4.5) | 47 (5.3) | 48 (5.5) | |
| 3–4 | 107 (1.8) | 78 (1.8) | 17 (1.9) | 12 (1.4) | |
| Ascites† | <0.001 | ||||
| 0 | 4167 (69.0) | 2941 (68.8) | 534 (60.1) | 692 (79.0) | |
| 1–2 | 1330 (22.0) | 957 (22.4) | 244 (27.4) | 129 (14.7) | |
| 3–4 | 545 (9.0) | 379 (8.9) | 111 (12.5) | 55 (6.3) | |
| Lymphedema | <0.001 | ||||
| 0 | 4598 (77.0) | 3414 (81.2) | 513 (57.4) | 671 (76.6) | |
| 1–2 | 990 (16.6) | 585 (13.9) | 271 (30.3) | 134 (15.3) | |
| 3–4 | 387 (6.5) | 207 (4.9) | 109 (12.2) | 71 (8.1) | |
| General oedema | <0.001 | ||||
| 0 | 2191 (37.0) | 1385 (32.6) | 271 (33.6) | 535 (61.8) | |
| 1–2 | 3131 (52.9) | 2446 (57.5) | 434 (53.8) | 251 (29.0) | |
| 3–4 | 601 (10.1) | 421 (9.9) | 101 (12.5) | 79 (9.1) | |
| Fatigue | <0.001 | ||||
| 0 | 138 (2.1) | 123 (2.6) | 8 (0.9) | 7 (0.8) | |
| 1–2 | 885 (13.8) | 689 (14.8) | 132 (14.6) | 64 (7.3) | |
| 3–4 | 5402 (84.1) | 3832 (82.5) | 765 (84.5) | 805 (91.9) | |
| Insomnia | <0.001 | ||||
| 0 | 3603 (59.6) | 2942 (68.9) | 363 (40.6) | 298 (34.0) | |
| 1–2 | 1913 (31.7) | 1012 (23.7) | 428 (47.9) | 473 (54.0) | |
| 3–4 | 525 (8.7) | 317 (7.4) | 103 (11.5) | 105 (12.0) | |
| Incontinence | <0.001 | ||||
| 0 | 2128 (35.5) | 1616 (38.2) | 244 (27.2) | 268 (30.6) | |
| 1–2 | 948 (15.8) | 525 (12.4) | 153 (17.0) | 270 (30.8) | |
| 3–4 | 2926 (48.8) | 2087 (49.4) | 501 (55.8) | 338 (38.6) | |
| Psychosocial/spiritual issues | |||||
| Awareness of diagnosis (patient) | <0.001 | ||||
| Well known | 4907 (71.6) | 3663 (71.9) | 626 (71.0) | 618 (70.8) | |
| Partial | 630 (9.2) | 281 (5.5) | 214 (24.3) | 135 (15.5) | |
| Unknown | 1315 (19.2) | 1153 (22.6) | 42 (4.8) | 120 (13.7) | |
| Awareness of prognosis (patient) | <0.001 | ||||
| Well known | 3312 (48.5) | 2300 (45.3) | 616 (69.8) | 396 (45.4) | |
| Partial | 1971 (28.9) | 1418 (27.9) | 226 (25.6) | 327 (37.5) | |
| Unknown | 1546 (22.6) | 1356 (26.7) | 40 (4.5) | 150 (17.2) | |
| Awareness of prognosis (family) | <0.001 | ||||
| Well known | 6279 (91.5) | 4548 (89.2) | 872 (98.4) | 859 (98.4) | |
| Partial | 528 (7.7) | 507 (9.9) | 10 (1.1) | 11 (1.3) | |
| Unknown | 53 (0.8) | 46 (0.9) | 4 (0.5) | 3 (0.3) | |
| Psychosocial issues (patient) | <0.001 | ||||
| Yes | 4745 (53.5) | 3580 (50.6) | 672 (73.2) | 493 (56.0) | |
| No | 4129 (46.5) | 3496 (49.4) | 246 (26.8) | 387 (44.0) | |
| Psychosocial issues (family) | <0.001 | ||||
| Yes | 6138 (69.2) | 4800 (67.8) | 791 (86.2) | 547 (62.2) | |
| No | 2736 (30.8) | 2276 (32.2) | 127 (13.8) | 333 (37.8) | |
| Spiritual issues (patient) | <0.001 | ||||
| Yes | 2017 (22.7) | 1554 (22.0) | 83 (9.0) | 380 (43.2) | |
| No | 6857 (77.3) | 5522 (78.0) | 835 (91.0) | 500 (56.8) | |
| Spiritual issues (family) | <0.001 | ||||
| Yes | 4302 (48.5) | 3731 (52.7) | 85 (9.3) | 486 (55.2) | |
| No | 4572 (51.5) | 3345 (47.3) | 833 (90.7) | 394 (44.8) | |
| Psychosocial spiritual care‡ | <0.001 | ||||
| Yes | 1319 (14.9) | 625 (8.8) | 547 (59.6) | 147 (16.7) | |
| No | 7555 (85.1) | 6451 (91.2) | 371 (40.4) | 733 (83.3) | |
*Statistical tests performed: Kruskal-Wallis test; Fisher’s exact test for count data with simulated p value (based on 2000 replicates).
†Grade of ascites: 0=No; 1=asymptomatic; 2=symptomatic, medical intervention indicated; 3=symptomatic, invasive procedure indicated; 4=life threatening consequences.
‡Psychosocial spiritual care: There are multiprofessional team members involved in the care, such as, music therapists and spiritual care worker.
DNR, do not resuscitation; ECOG, Eastern Cooperative Oncology Group; HHC, hospice home care; HIC, hospice inpatient care; HSC, hospice share care.