Current Status of the Pediatric Palliative Care Pilot Project in South Korea Based on the Experience of a Single Center.

Sun Hee Choi, Na Ri Yoon, Yeonhee Lee
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Abstract

Purpose: We evaluated the status of patients enrolled in South Korea's pediatric palliative care pilot project based on the experience of a single center. This study examined factors related to end-of-life services and differences in medical costs.

Methods: The medical records of 120 patients referred by a pediatric palliative care team were analyzed retrospectively. Data from July 1 to February 28, 2022 were collected and analyzed using the chi-square test and the Mann-Whitney U test.

Results: Volunteer programs and psychological support (100%), family support and education (99.2%), and financial support through institutional linkage (62.5%) were provided to the participants. In the deceased group, there were no significant differences in general characteristics, which included age, gender, primary disease, religion, duration of hospitalization in an intensive care unit (ICU) and non-intensive care unit (non-ICU). However, the ICU group had fewer opportunities to access individual pain and physical symptom management than the non-ICU group and there were limitations in linking with external resources. Medical expenses were significantly different for the ICU group, with a 3-times higher average cost than the non-ICU group.

Conclusion: Although an individualized approach is needed for each patient in pediatric palliative care, psychosocial care is essential. In addition, if early intervention for end-of-life pediatric patients is available from a palliative care team, the cost burden of medical care for patients and their families should be minimal.

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基于单一中心经验的韩国儿科姑息治疗试点项目的现状。
目的:我们根据单一中心的经验,评估了韩国儿科姑息治疗试点项目的患者状况。这项研究考察了与临终服务和医疗费用差异相关的因素。方法:回顾性分析儿科姑息治疗团队转诊的120例患者的病历。使用卡方检验和Mann-Whitney U检验收集并分析2022年7月1日至2月28日的数据。结果:志愿者项目和心理支持(100%)、家庭支持和教育(99.2%)以及通过机构联系提供的经济支持(62.5%)都提供给了参与者。在死亡组中,一般特征没有显著差异,包括年龄、性别、原发性疾病、宗教、在重症监护室(ICU)和非重症监护室的住院时间。然而,与非ICU组相比,ICU组获得个体疼痛和身体症状管理的机会更少,并且在与外部资源的联系方面存在局限性。ICU组的医疗费用差异显著,平均费用是非ICU组的3倍。结论:尽管在儿科姑息治疗中需要为每位患者提供个性化的治疗方法,但心理社会护理是必不可少的。此外,如果姑息治疗团队可以对临终儿科患者进行早期干预,那么患者及其家人的医疗费用负担应该是最小的。
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