Home-based Hospice-palliative Care Service Administered by University-based Family Practice

Background: Systematic care is not well provided in patients with terminal cancer and their families in Korea. Unnecessary hospitalization, multiple emergency room visits for controlling acute symptoms and the use of unqualified alternative care services are typical health care utilization patterns in such patients. We operated home-based hospice-palliative care services to help these patients and their families at a university-based family practice setting. Our experience is presented for the development of care model of hospice-palliative care services. Methods: We investigated the demographic characteristics, the clinical findings and the utilization of medical care services of 72 terminally ill cancer patients before and after enrollment to hospice-palliative care unit from April 25, 2003 to April 21, 2005. Results: The frequency of emergency room visits and the number of hospitalizations were decreased by Wicoxon Signed Ranks Test after the enrollment to home-based hospice-palliative care service unit. The duration of emergency room visits decreased from 7.7 hours to 0.3 hours and the duration of hospitalization decreased from 6.5 days to 0.0 days in median. The cost per emergency room visits decreased from 268,801 won to 153,816 won and the cost per hospitalization decreased from 285,491 won to 106,294 won in median. Conclusion: Home-based hospice-palliative care services can be an efficient and effective model for the care of terminally ill cancer patients at a low cost.