Accessibility to Palliative Care for Non-Cancer Patients Near the End of Life: The Obstacles and Opportunities

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Abstract

Background: Understanding the prevalence and associated factors of accessibility to palliative care among non-cancer patients can promote the quality of life. However, data in this area of Thailand are limited. Objective: To investigate the prevalence and associated factors of non-cancer patients’ access to palliative treatment. Materials and Methods: A cross-sectional study was performed by a retrospective medical chart review of non-cancer patients admitted and later pronounced dead at Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Thailand. The accessibility to the palliative care system was collected using the authors’ modification of the Supportive and Palliative Care Indicators Tool (SPICT). All data were analyzed by using the chi-square test and the binary logistic regression model, respectively. Results: The prevalence of accessibility to palliative care among non-cancer patients was 15.69%. Non-cancer patients with renal and liver failure were significantly associated with accessibility to palliative care (adjusted OR 4.742, p=0.002 and 6.159, p=0.011, respectively). Conclusion: Prevalence of access to palliative care in non-cancer patients was 15.69%. Organ failure in non-cancer patients with renal and hepatic systems can boost accessibility to palliative treatment. There were few palliative patients without cancer that accessed palliative care service. Additionally, it is critical for healthcare professionals to be educated on the fundamentals of palliative care. Keywords: Non-cancer patients; Prevalence; Accessibility; Palliative care
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临终前非癌症患者获得姑息治疗:障碍与机遇
背景:了解非癌症患者获得姑息治疗的患病率及相关因素可提高患者的生活质量。然而,泰国这一地区的数据有限。目的:了解非肿瘤患者接受姑息治疗的情况及相关因素。材料和方法:通过对泰国斯利那卡林威罗大学Panyananthaphikkhu Chonprathan医疗中心入院后宣布死亡的非癌症患者的回顾性医疗图表进行横断面研究。使用作者修改的支持和姑息治疗指标工具(SPICT)收集姑息治疗系统的可及性。所有数据分别采用卡方检验和二元logistic回归模型进行分析。结果:非肿瘤患者可及性姑息治疗患病率为15.69%。非癌症患者肾和肝功能衰竭与姑息治疗可及性显著相关(调整后OR分别为4.742,p=0.002和6.159,p=0.011)。结论:非肿瘤患者姑息治疗可及率为15.69%。肾脏和肝脏系统的非癌症患者的器官衰竭可以提高姑息治疗的可及性。没有癌症的姑息病人很少接受姑息治疗服务。此外,对医疗保健专业人员进行姑息治疗基础知识的教育也是至关重要的。关键词:非肿瘤患者;患病率;可访问性;姑息治疗
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