scholarly journals Prevalence of the Z515 (Palliative Care) Diagnosis from the ICD-10 System in Cancer Patients and the Relationship between Treatment and Cost in Songklanagarind Hospital

2018 ◽  
Vol 36 (4) ◽  
Author(s):  
Orapan Fumaneeshoat
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Average Cost ◽  
Data Extraction ◽  
Diagnostic System ◽  
Healthcare Services ◽  
Diagnostic Code ◽  
Icd 10 ◽  
The Government ◽  
The Relationship

Objective: To determine the prevalence of use of the diagnostic system ICD-10 code Z515 in patients diagnosed with cancer and the relationship between treatment and cost in Songklanagarind Hospital during the 2012-2016 period. Material and Methods: A retrospective descriptive study was performed in patients who were diagnosed as code Z515 in Songklanagarind Hospital from 2012-2016. Data were collected through the Hospital Information System (HIS), and the patients were divided into 2 groups based on whether they were Inpatient Department (IPD) or Outpatient Department (OPD). From the HIS, data concerning sex, age, the right of access to healthcare services, date of diagnosis, first and last department that diagnosed the Z515 code, other departments that diagnosed the same code, other codes diagnosed besides Z515, the latest treatment received, number of regularly-used medications, symptoms that persisted according to the most recent record, ward name, duration of hospitalization (for IPD cases), and the average cost of treatment were recorded on data extraction forms and analyzed as percentages with 95% confidence interval and odds ratios. Results: The prevalence of the diagnostic code Z515 in cancer patients during the study period was 0.2% in both inand outpatients. For outpatient the relationship between average cost and number of medications and average cost and type of treatment were statistically significantly different, while for inpatients the difference was not statistically significant. Conclusion: In Songklanagarind Hospital the use of code Z515 is very low, even though we know that all cancer patients should get the best palliative care support and the earlier we diagnose them as palliative, the better the care they will receive. Therefore, if the doctors are aware of this code, the patient will receive the best care in their end stages of life, and that would make them and their families feel happier. Moreover, our hospital will get reimbursement from the government to get more resources. Hence, more patients can be helped. Songklanagarind Hospital should undertake some kind of program to ensure all physicians are aware of code Z515 and how to use it in order to provide the best care for end-of-life patients.

HSR19-076: A Prospective Study of the Usage of Pain Medication, Cost, Alternative Medication Use, and Outcome by Cancer Patients in Real World

2019 ◽  
Vol 17 (3.5) ◽  
pp. HSR19-076
Author(s):  
Praveen Adusumilli ◽  
Vidya Viswanath ◽  
Raghunadha Rao Digumarthi
Keyword(s):  
Palliative Care ◽  
Side Effects ◽  
Cancer Patients ◽  
Average Cost ◽  
Pain Medication ◽  
Cancer Center ◽  
Medication Cost ◽  
Palliative Care Specialist ◽  
Care Specialist ◽  
A Prospective Study

Introduction: Perception of pain and the need to treat it is highly variable, even amongst oncologists. Availability of pain specialists is an added advantage. This is an analysis of prescription patterns of pain medication and its outcome in cancer patients. Materials and Methods: The center has 8 oncologists and a pain and palliative care specialist. All the patients presenting to the outpatient department of our institute with a diagnosis of cancer were prospectively analyzed for usage of pain medication using a structured questionnaire. Data on diagnosis, stage, treatment given, and outcomes were analyzed. Pain intensity was recorded on visual analogue scale, types of pain medicines used, and their side effects were noted. The average cost of the pain medication purchased in our pharmacy was calculated. Use of alternative medicines was also noted. Results: A total of 1,098 cancer patients were evaluated. Pain was a prominent complaint in 64.6% of patients. Of these, only 89.5% received pain medication. Mild, moderate, and severe pain was seen in 52.1%, 26.7%, and 21.2% respectively. The 3 most common diagnoses were breast cancer in 19.7%, gastrointestinal cancer in 14%, and 12.1% with head and neck cancers. Weak opioids and NSAIDS were most commonly prescribed analgesics in 44.2% and 42.1%, respectively. Morphine was prescribed for 13.7% of patients. The average cost of pain medicines is Re 148 (US $2.25 a month). Side effects from medication were seen in 13.5% of patients, with constipation being the most common. Alternative forms of medicine were reportedly used by 148 patients: Ayurveda by 20.8%, and homeopathy by 12.9%, native medication by 6.1%, Unani by 1.8%. Good relief of pain was reported by 66%, fair relief by 27%, no relief by 6.1%, and worsening by <1%. Conclusion: Pain management is near ideal with the availability of services of pain and palliative care specialist in a cancer center.

scholarly journals Discussing the Effect of Medical Team Model in the Hospice Palliative Care to Terminal Cancer Patient

2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Chia Hsing Wu
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Care Program ◽  
Team Work ◽  
Terminal Cancer ◽  
Medical Team ◽  
Terminally Ill Cancer Patients ◽  
The Relationship ◽  
Hospice Palliative Care ◽  
Team Model

One of the main purposes of the hospice-palliative care program is to provide a hospice for the terminally ill cancer patients. Weisman assumed that a hospice should consist of five aspects which include Awareness of the end of life, Acceptance, Proprietary, Timing and Comfort. Therefore, the purpose of this research is to explore firstly the condition of the terminal cancer patients in the hospice. Secondly to Investigate the effect of Medical team work method and finally to compare the relationship between the hospice score and service result

scholarly journals Penghematan Biaya Perawatan Pasien Kanker Terminal Dewasa melalui Konsultasi Tim Paliatif di Rumah Sakit Dr. Cipto Mangunkusumo

2017 ◽  
Vol 4 (1) ◽  
pp. 35 ◽  
Author(s):  
Rudi Putranto ◽  
Laksono Trisnantoro ◽  
Yos Hendra
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Significant Relationship ◽  
End Of Life Care ◽  
Terminal Cancer ◽  
Life Care ◽  
Palliative Care Consultation ◽  
Terminal Cancer Patients ◽  
Care Consultation ◽  
The Relationship

Pendahaluan. Meningkatnya penderita kanker terminal di Indonesia akan meningkatkan kebutuhan perawatan paliatif dan akhir kehidupan (palliative and end of life care). Pelayanan kesehatan pada pasien kanker membebani rumah sakit, karena menyebabkan biaya tinggi dan lama rawat memanjang. Penelitian ini bertujuan untuk mengevaluasi hubungan lama rawat inap dan tarif pelayanan rawat inap pasien kanker terminal dewasa dengan intervensi paliatif di Rumah Sakit dr. Cipto Mangunkusumo (RSCM).Metode. Penelitian ini adalah deskriptif analitik dengan desain kasus kontrol dan dilakukan di ruang rawat inap RSCM Jakarta selama bulan Januari–Desember 2015. Subjek adalah pasien kanker terminal dewasa di rawat inap kelas III pada tahun Januari-Desember 2015 dengan penjamin Badan Penyelenggara Jaminan Sosial (BPJS). Data diperoleh dari data rekam medis dan billing dan dianalisis menggunakan uji Mann-Whitney.Hasil. Diketahui bahwa terdapat hubungan yang signifikan antara intervensi paliatif dengan pengeluaran pasien sesuai tarif RS (p=0,041), sedangkan tidak terdapat hubungan signifikan antara intervensi paliatif dengan lama hari rawat (p=0,873). Terdapat hubungan bermakna antara intervensi paliatif dan tarif pengeluaran kamar, visite, tindakan dan obat dan intervensi paliatif.Simpulan. Terdapat hubungan yang signifikan antara intervensi paliatif dengan pengeluaran pasien sesuai tarif RS. Terdapat hubungan bermakna antara intervensi paliatif dan tarif pengeluaran kamar, visite, tindakan dan obat dan intervensi paliatif.Kata Kunci: intervensi, lama rawat, perawatan paliatif, tarif Cost of Care Saving of Terminal Cancer Adult Patient Using Palliative Care Consultation in Cipto Mangunkusumo HospitalIntroduction. Terminal cancer patients was increasing in Indonesia, and need attention to approach palliative and end of life care. Terminal cancer management was burden the hospital, because it causes high costly and the length of stay This study aimed to get a general picture of service palliative at Cipto Mangunkusumo, then to evaluate the relationship hospitalization and rates of inpatient services people with terminal cancer adults who received the intervention palliative care and to evaluate the relationship variable rates for accommodation (room), doctor visit, procedure/surgery, medicines and consumables, laboratory and radiology to palliative interventions in patients with terminal cancer in inpatient Dr. Cipto Mangunkusumo Hospital. Methods. This research was descriptive study with case control design and performed in the inpatient unit, Dr Cipto Mangunkusumo Hospital, during the month of January to December 2015. The subjects were medical records and billing of terminal cancer patients were .hospitalized adults in class III in January - December 2015 with National Health Insurance (BPJS). Inclusion criteria are terminal cancer patients, beusia ≥ 18 years, received palliative care consultation team while exclusion criteria are patients receiving palliative consultation on treatment days ≥ 25 days.Results. It is known that there is a significant relationship between palliative interventions to patients with hospital rates (p= 0.041), whereas there was no significant relationship between palliative interventions by the length of stay (p = 0.873). There is a significant relationship between palliative interventions and expenditures room rates, visite, action and medicine and palliative interventions.Conclusions. There is a significant relationship between palliative interventions with hospital rates. There is a significant relationship between palliative interventions and expenditures room rates, visite, action and medicine and palliative interventions. These data showed that palliative care intervention was saving money for hospital. 

Quality of life and satisfaction with care among palliative cancer patients in Saudi Arabia

2016 ◽  
Vol 14 (6) ◽  
pp. 621-627 ◽  
Author(s):  
Ahmad Aboshaiqah ◽  
Turki Suwaylim B. Al-Saedi ◽  
Mohammed Munawir M. Abu-Al-Ruyhaylah ◽  
Abdulrahman Abed Aloufi ◽  
Muteb Omtairan Alharbi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Saudi Arabia ◽  
Health Status ◽  
Global Health ◽  
Cancer Patients ◽  
Satisfaction With Care ◽  
Emotional Function ◽  
The Relationship

AbstractObjective:This study aimed to determine the relationship between quality of life and satisfaction with care among cancer patients in palliative care in Saudi Arabia.Methods:A total of 130 palliative cancer patients were invited to participate in our cross-sectional study. Patients were recruited from a large tertiary hospital within the Ministry of Health in Saudi Arabia. All eligible participants answered a three-part questionnaire that included demographic data and the validated European Organization for Research and Treatment of Cancer (EORTC QLQ–C15–PAL) and (EORTC IN-PATSAT32) questionnaires.Results:Participants were mostly female (103/130, 79%) and married (93/130, 71%), and more than half had breast cancer (69/130, 53%). They were between 17 and 86 years of age (mean = 46.7, SD = 16.50). The correlation test showed that the relationship with physical function was weak, while emotional function and global health status had a moderate relationship with general satisfaction (r = 0.21, p < 0.01; r = 0.32, p < 0.001; r = 0.26, p < 0.01, respectively). Our results suggest that emotional function is the more important factor in predicting satisfaction with care among palliative cancer patients. An increase in emotional function leads to increased general satisfaction.Significance of results:The emotional function of palliative cancer patients was more closely associated with overall satisfaction with care than physical function or global health status. All palliative care team members are thus required to provide adequate psychosocial support. It is recommended that interdisciplinary and collaborative approaches be integrated in palliative care of cancer patients.

The Use of Healthcare Services by Prostate Cancer Patients in the Last 12 Months of Life: How Do We Improve the Quality of Care During This Period?

2020 ◽  
pp. 082585972097594
Author(s):  
Tony Tien ◽  
Evangelos Gkougkousis ◽  
Paula Allchorne ◽  
James S. A. Green
Keyword(s):  
Prostate Cancer ◽  
Palliative Care ◽  
Cancer Patients ◽  
Quality Care ◽  
Cost Effective ◽  
Healthcare Services ◽  
Care Needs ◽  
Prostate Cancer Survivors ◽  
New Treatments

Introduction: Current research on prostate cancer is heavily focused on early detection and new treatments. There is a lack of research on the overall morbidity prostate cancer survivors face and the amount of healthcare treatment they receive toward the end of their lives. Identifying these care needs will allow appropriate healthcare modeling, resource allocation and service re-design to ensure higher quality care toward the end of life. The aim of this study is to quantify and analyze the use of healthcare services by patients dying with but not necessarily of prostate cancer. Methods: All patients who died with a diagnosis of prostate cancer during a 2-year period at a single hospital were included. Data on outpatient attendances, elective and emergency admissions and palliative care involvement in the 12 months prior to death were collected. Results: A total of 77 patients were included and of these, 60 (78.0%) had 545 scheduled appointments with 473 (86.8%) attendances. More non-attendances occurred in the last 6 months of life; 56 vs 16, p < 0.001. Nurse led clinics doubled in the last 6 months of life, 117 vs 66. There were 173 admissions from 63 (81.8%) patients resulting in 1816 days inpatient stay. This averaged to 2.7 admissions per patient for 10.5 days per episode. 32 (41.6%) patients were seen by palliative care resulting in 192 visits in total. 78 (40.6%) were inpatient and 114 (59.4%) were community reviews. Conclusions: In the last year of life, prostate cancer patients use a considerable amount of healthcare resources. Understanding this clinical and economical burden is important for healthcare remodeling to provide better quality care that is cost effective.

scholarly journals Discussing the Effect of Medical Team Method in the Hospice Palliative Care to Terminal Cancer Patient

2018 ◽  
Vol 2 (3) ◽  
Author(s):  
Chia Hsing Wu
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Terminally Ill ◽  
Care Program ◽  
Team Work ◽  
Terminal Cancer ◽  
Medical Team ◽  
Terminally Ill Cancer Patients ◽  
The Relationship ◽  
Hospice Palliative Care

One of the main purposes of the hospice-palliative care program is to provide a hospice for the terminally ill cancer patients. Weisman assumed that a hospice should consist of five aspects which include Awareness of the end of life, Acceptance, Proprietary, Timing and Comfort. Therefore, the purpose of this research is to explore firstly the condition of the terminal cancer patients in the hospice. Secondly to Investigate the effect of Medical team work method and finally to compare the relationship between the hospice score and service result [1]. Materials Go to This study involved subjects from those from the terminally ill cancer patients who passed away in the hospice palliative care unit at medical Centre during 2012-2013. There were a total of 292 patients considered for the study. Thirty patients were excluded from the study because there was data missing from their file. The remaining 262 patients information was collected on 157males (53.8%) and 105 females (36%).

scholarly journals A qualitative study of bereaved family caregivers: feeling of security, facilitators and barriers for rural home care and death for persons with advanced cancer

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne Sæle Barlund ◽  
Beate André ◽  
Kari Sand ◽  
Anne-Tove Brenne
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Rural Areas ◽  
Healthcare Professionals ◽  
Healthcare Services ◽  
Personal Factors ◽  
At Home

Abstract Background For cancer patients and their family, an important factor that determines the choice to die at home is the caregivers’ feeling of security when caring for the patient at home. Support to caregivers from healthcare professionals is important for the feeling of security. In rural areas, long distances and variable infrastructure may influence on access to healthcare services. This study explored factors that determined the security of caregivers of patients with advanced cancer who cared for the patients at home at the end of life in the rural region of Sogn og Fjordane in Norway, and what factors that facilitated home death. Methods A qualitative study using semi-structured in-depth interviews with bereaved with experience from caring for cancer patients at home at the end of life was performed. Meaning units were extracted from the transcribed interviews and divided into categories and subcategories using Kvale and Brinkmann’s qualitative method for analysis. Results Ten bereaved caregivers from nine families where recruited. Five had lived together with the deceased. Three main categories of factors contributing to security emerged from the analysis: “Personal factors”, “Healthcare professionals” and “Organization” of healthcare. Healthcare professionals and the organization of healthcare services contributed most to the feeling of security. Conclusion Good competence in palliative care among healthcare professionals caring for patients with advanced cancer at home and well- organized palliative care services with defined responsibilities provided security to caregivers caring for advanced cancer patients at home in Sogn og Fjordane.

scholarly journals Spatial effects of environmental pollution on healthcare services: Evidence from China

2021 ◽  
Author(s):  
Ying Mao ◽  
Ning Zhang
Keyword(s):  
Environmental Pollution ◽  
Solid Waste ◽  
Rapid Development ◽  
Northern China ◽  
Healthcare Services ◽  
Spatial Effects ◽  
The Government ◽  
Using Data ◽  
The Impact ◽  
The Relationship

With the rapid development of urbanization and industrialization in China, environmental issues have become a knotty problem, especially issues related to air, water, and solid-waste pollution. These pollutants pose threats to the health of the population and to that of communities and have a vicious influence on the healthcare system. Additionally, pollution also exhibits spill-over effects, which means that pollution in the local region could affect the healthcare services in a neighbouring region. Therefore, it is necessary to explore the relationship between pollution and healthcare. A spatial autocorrelation analysis was conducted and spatial panel econometric models were constructed to explore the characteristics of pollution and healthcare services in China and the relationship between them using data on all 31 provinces over twelve consecutive years (2006-2017). The results showed that the utilization of healthcare services and environmental pollution were not randomly distributed; unsurprisingly, air pollution and solid-waste pollution were mainly found in parts of northern China, while water pollution was highest in southern and coastal China. In addition, environmental pollution exhibited spill-over effects on healthcare services. For example, a 1% increase in solid waste in one specific geographical unit was estimated to increase the inpatient visits per capita in adjacent counties by 0.559%. Specifically, pollution showed different degrees of influence on healthcare services, which means that the impact of environmental pollution on the number of outpatient visits is greater than on the number of inpatient visits. Our results provide the government with evidence for effectively formulating and promulgating policies, especially policies aimed at tackling spill-over effects among different regions.

scholarly journals Exploring key stakeholders’ attitudes and opinions on medical assistance in dying and palliative care in Canada: a qualitative study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055789
Author(s):  
Gilla K Shapiro ◽  
Eryn Tong ◽  
Rinat Nissim ◽  
Camilla Zimmermann ◽  
Sara Allin ◽  
...  
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
Policy Development ◽  
Qualitative Interview ◽  
Medical Assistance ◽  
Medical Assistance In Dying ◽  
Key Stakeholders ◽  
The Government ◽  
The Impact ◽  
The Relationship

IntroductionCanadians have had legal access to medical assistance in dying (MAiD) since 2016. However, despite substantial overlap in populations who request MAiD and who require palliative care (PC) services, policies and recommended practices regarding the optimal relationship between MAiD and PC services are not well developed. Multiple models are possible, including autonomous delivery of these services and formal or informal coordination, collaboration or integration. However, it is not clear which of these approaches are most appropriate, feasible or acceptable in different Canadian health settings in the context of the COVID-19 pandemic and in the post-pandemic period. The aim of this qualitative study is to understand the attitudes and opinions of key stakeholders from the government, health system, patient groups and academia in Canada regarding the optimal relationship between MAiD and PC services.Methods and analysisA qualitative, purposeful sampling approach will elicit stakeholder feedback of 25–30 participants using semistructured interviews. Stakeholders with expertise and engagement in MAiD or PC who hold leadership positions in their respective organisations across Canada will be invited to provide their perspectives on the relationship between MAiD and PC; capacity-building needs; policy development opportunities; and the impact of the COVID-19 pandemic on the relationship between MAiD and PC services. Transcripts will be analysed using content analysis. A framework for integrated health services will be used to assess the impact of integrating services on multiple levels.Ethics and disseminationThis study has received ethical approval from the University Health Network Research Ethics Board (No 19-5518; Toronto, Canada). All participants will be required to provide informed electronic consent before a qualitative interview is scheduled, and to provide verbal consent prior to the start of the qualitative interview. Findings from this study could inform healthcare policy, the delivery of MAiD and PC, and enhance the understanding of the multilevel factors relevant for the delivery of these services. Findings will be disseminated in conferences and peer-reviewed publications.

Sign in / Sign up

Export Citation Format

Share Document