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. 

scholarly journals Low Socioeconomic Status Is Associated With More Aggressive End‐of‐Life Care for Working‐Age Terminal Cancer Patients

2014 ◽  
Vol 19 (12) ◽  
pp. 1241-1248 ◽  
Author(s):  
Chun‐Ming Chang ◽  
Chin‐Chia Wu ◽  
Wen‐Yao Yin ◽  
Shiun‐Yang Juang ◽  
Chia‐Hui Yu ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
End Of Life ◽  
Cancer Patients ◽  
Low Socioeconomic Status ◽  
End Of Life Care ◽  
Terminal Cancer ◽  
Life Care ◽  
Low Socioeconomic ◽  
Terminal Cancer Patients ◽  
Working Age

mHOMR: a feasibility study of an automated system for identifying inpatients having an elevated risk of 1-year mortality

2019 ◽  
pp. bmjqs-2018-009285 ◽  
Author(s):  
Pete Wegier ◽  
Ellen Koo ◽  
Shahin Ansari ◽  
Daniel Kobewka ◽  
Erin O'Connor ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Feasibility Study ◽  
Mortality Risk ◽  
End Of Life Care ◽  
Elevated Risk ◽  
Life Care ◽  
Risk Of Death ◽  
Palliative Care Consultation ◽  
Care Consultation

ObjectiveThe need for clinical staff to reliably identify patients with a shortened life expectancy is an obstacle to improving palliative and end-of-life care. We developed and evaluated the feasibility of an automated tool to identify patients with a high risk of death in the next year to prompt treating physicians to consider a palliative approach and reduce the identification burden faced by clinical staff.MethodsTwo-phase feasibility study conducted at two quaternary healthcare facilities in Toronto, Canada. We modified the Hospitalised-patient One-year Mortality Risk (HOMR) score, which identifies patients having an elevated 1-year mortality risk, to use only data available at the time of admission. An application prompted the admitting team when patients had an elevated mortality risk and suggested a palliative approach. The incidences of goals of care discussions and/or palliative care consultation were abstracted from medical records.ResultsOur model (C-statistic=0.89) was found to be similarly accurate to the original HOMR score and identified 15.8% and 12.2% of admitted patients at Sites 1 and 2, respectively. Of 400 patients included, the most common indications for admission included a frailty condition (219, 55%), chronic organ failure (91, 23%) and cancer (78, 20%). At Site 1 (integrated notification), patients with the notification were significantly more likely to have a discussion about goals of care and/or palliative care consultation (35% vs 20%, p = 0.016). At Site 2 (electronic mail), there was no significant difference (45% vs 53%, p = 0.322).ConclusionsOur application is an accurate, feasible and timely identification tool for patients at elevated risk of death in the next year and may be effective for improving palliative and end-of-life care.

The Optimal Delivery of Palliative Care (DRAFT)

2018 ◽  
Author(s):  
Jaclyn Yoong ◽  
Peter Poon
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Models Of Care ◽  
Global Rating ◽  
Life Care ◽  
Palliative Care Consultation ◽  
Care Consultation ◽  
Excellent Care ◽  
Veterans Affairs Medical Centers

This study aimed to compare the effect of palliative care consultation teams with that of dedicated palliative care units on the quality of end-of-life care. This was a telephone-base survey conducted in 77 Veterans Affairs medical centers that had provided both models of care. Deceased patients from July 2008 to December 2009 were identified. A family member of the decedent was invited to participate in the survey which consisted of one global rating item and nine core items pertaining to patient’s end-of-life care. Families of patients who received care in a palliative care unit were more likely to report “excellent” care compared to families of those who received at least one palliative care consultation; families of those who received at least one palliative care consultation in turn where more likely to report “excellent” care compared to families of those who received usual care.

scholarly journals Impact of Hospital Case Volume on Quality of End-of-Life Care in Terminal Cancer Patients

2013 ◽  
Vol 16 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Toshitaka Morishima ◽  
Jason Lee ◽  
Tetsuya Otsubo ◽  
Hiroshi Ikai ◽  
Yuichi Imanaka
Keyword(s):  
End Of Life ◽  
Cancer Patients ◽  
End Of Life Care ◽  
Terminal Cancer ◽  
Life Care ◽  
Case Volume ◽  
Hospital Case ◽  
Terminal Cancer Patients

scholarly journals Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent

2021 ◽  
Vol 19 (1) ◽  
pp. 428
Author(s):  
Hui-Mei Lin ◽  
Chih-Kuang Liu ◽  
Yen-Chun Huang ◽  
Chieh-Wen Ho ◽  
Mingchih Chen
Keyword(s):  
Palliative Care ◽  
Logistic Regression ◽  
Regression Analysis ◽  
End Of Life ◽  
Logistic Regression Analysis ◽  
End Of Life Care ◽  
Life Care ◽  
Do Not Resuscitate ◽  
Palliative Care Consultation ◽  
Care Consultation

Background: The decision to sign a do-not-resuscitate (DNR) consent is critical for patients concerned about their end-of-life medical care. Taiwan’s National Health Insurance Administration (NHIA) introduced a family palliative care consultation fee to encourage family palliative care consultations; since its implementation, identifying which families require such consultations has become more important. In this study, the Taiwanese version of the Palliative Care Screening Tool (TW–PCST) was used to determine each patient’s degree of need for a family palliative care consultation. Objective: This study analyzed factors associated with signing DNR consents. The results may inform family palliative care consultations for families in need, thereby achieving a higher DNR consent rate and promoting the effective use of medical resources, including time, labor, and funding. Method: In this retrospective study, logistic regression analysis was conducted to determine which factors affected the DNR decisions of 2144 deceased patients (aged ≥ 20 years), whose records were collected from the Taipei City Hospital health information system from 1 January to 31 December 2018. Results: Among the 1730 patients with a DNR consent, 1298 (75.03%) received family palliative care consultations. The correlation between DNR consent and family palliative care consultations was statistically significant (p < 0.001). Through logistic regression analysis, we determined that participation in family palliative care consultation, TW–PCST score, type of ward, and length of stay were significant variables associated with DNR consent. Conclusions: This study determined that TW–PCST scores can be used as a measurement standard for the early identification of patients requiring family palliative care consultations. Family palliative care consultations provide opportunities for patients’ family members to participate in discussions about end-of-life care and DNR consent and provide patients and their families with accurate medical information regarding the end-of-life care decision-making process. The present results can serve as a reference to increase the proportion of patients willing to sign DNR consents and reduce the provision of ineffective life-prolonging medical treatment.

End-of-Life Care, Palliative Care Consultation, and Palliative Care Referral in the Emergency Department: A Systematic Review

2020 ◽  
Vol 59 (2) ◽  
pp. 372-383.e1 ◽  
Author(s):  
Jennifer G. Wilson ◽  
Diana P. English ◽  
Clark G. Owyang ◽  
Erica A. Chimelski ◽  
Corita R. Grudzen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Palliative Care Consultation ◽  
Care Consultation

The Prevalence of Palliative Care Consultation in Deceased COVID-19 Patients and Its Association with End-of-Life Care

2021 ◽  
Author(s):  
Stephanie Golob ◽  
Robert Zilinyi ◽  
Sarah Godfrey ◽  
Ersilia M. DeFilippis ◽  
Justin Fried ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Palliative Care Consultation ◽  
Care Consultation

End of Life Care and Withdrawal of Life Support

2020 ◽  
Author(s):  
Craig Chen
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Palliative Medicine ◽  
Life Support ◽  
Life Care ◽  
Palliative Care Consultation ◽  
Surgical Icu ◽  
Care Consultation

Despite advances in critical care medicine and resuscitation, many patients who are admitted to the intensive care unit (ICU) will ultimately die. Although outcomes may be better for surgical rather than medical ICU patients, addressing the end of life is a fundamental and necessary aspect of critical care for all patients. Over the last few years, we have increasingly recognized the role of palliative care in the surgical and trauma ICU. Palliative medicine in the surgical ICU setting results in decreased length of stay, improved communication with family and patients, and earlier identification of goals of care. This review covers indications for palliative care consultation, practical considerations at the end of life, withdrawal of mechanical ventilation, and symptoms and symptom management at the end of life. Tables list the American College of Surgeons statement on the principles guiding care at the end of life, guidelines for palliative care consultation in the surgical ICU, ABCDs of dignity-conserving care, palliative care principles on transitioning a patient to comfort measures only, and the process of withdrawing ventilatory support. This review 5 tables, and 33 references. Key words: comfort measures; end of life; intensive care unit end-of-life care; palliation; palliative care; palliative care consultation; palliative medicine; quality of dying; withdrawal of life support

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