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Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
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Decision Tree Model for Predicting Hospice Palliative Care Use in Terminal Cancer Patients.

Hee-Ja Lee1, Im-Il Na2, Kyung-Ah Kang3

  • 1Special Nursing Team, Korea Institute of Radiological & Medical Sciences, Seoul, Korea.

Journal of Hospice and Palliative Care
|September 7, 2023
PubMed
Summary
This summary is machine-generated.

Terminal cancer patients who live with others, receive pain control, and die within two months of a Physician Orders for Life-Sustaining Treatment (POLST) are most likely to use hospice and palliative care (HPC). This finding aids timely HPC decisions.

Keywords:
Advance directivesDecision treesHospicesNeoplasmsPalliative care

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Area of Science:

  • Oncology
  • Palliative Care
  • Health Services Research

Background:

  • Timely access to hospice and palliative care (HPC) is crucial for patients with terminal cancer.
  • Physician Orders for Life-Sustaining Treatment (POLST) are critical documents for end-of-life care planning.
  • Understanding factors influencing HPC utilization is essential for developing clinical guidelines.

Purpose of the Study:

  • To develop clinical guidelines for appropriate timing of hospice and palliative care (HPC) utilization.
  • To identify characteristics of HPC use among terminal cancer patients who have completed Physician Orders for Life-Sustaining Treatment (POLST).

Main Methods:

  • Retrospective study involving 394 terminal cancer patients in Seoul, South Korea.
  • Decision tree analysis was employed to identify patterns in HPC utilization.
  • Data collected from January 1, 2019, to March 31, 2021, including POLST completion.

Main Results:

  • A predictive model identified three key factors for HPC use: cohabitation, pain control, and time to death after POLST.
  • Terminal cancer patients with a cohabitant, receiving pain control, and dying within 2 months of POLST had an 87.5% HPC usage rate.
  • Having a cohabitant significantly increased HPC use (55.1%) compared to those without (1.7%).

Conclusions:

  • This study offers valuable clinical insights for optimizing HPC decision-making.
  • The findings can assist clinicians and patients in determining the appropriate time for initiating HPC services.
  • Evidence supports the importance of considering patient living situation and symptom management in end-of-life care planning.