:::

詳目顯示

回上一頁
題名:生命末期照顧如何達到好的成本效益
書刊名:安寧療護
作者:黃馨葆蔡兆勳陳慶餘邱泰源 引用關係
作者(外文):Huang, Sin-baoTsai, Jaw-shiunChen, Ching-yuChiu, Tai-yuan
出版日期:2011
卷期:16:2
頁次:頁205-216
主題關鍵詞:緩和醫療生命末期照顧成本效益Palliative careEnd-of-life careCost-effective
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(9) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:9
  • 共同引用共同引用:6
  • 點閱點閱:95
根據世界衛生組織的建議,生命末期照護的首要目標是生活品質的提昇,而不是極盡的延長生命,因為這個目標已經難以達成。試圖延命的醫療措施在末期病人經常變成所謂的無效醫療,病人在醫療過程中飽受痛苦,醫療資源的使用更是可觀。安寧緩和醫療是提供有生命威脅的病人與家屬,從診斷到死亡的疼痛及其他症狀的緩解、心理和靈性的支持與悲傷輔導,其目標是提昇生活品質。根據國內外的經驗與實證,提供末期病人安寧緩和醫療確實能緩解身體症狀、減緩心理情緒反應、提升內在力量減少死亡恐懼,改善生活品質,繼而達到善終。本文章藉由文獻回顧,從病人之成本、家屬及照顧者之成本與醫療體系之成本三方面做醫療成本探討,著重症狀控制、心理情緒、病人及家屬之生活品質、滿意度等面向。安寧緩和醫療不僅有好的照顧品質,還能節省醫療資源的使用,對末期病人的照顧能達到較佳的成本效益。
According to WHO, the major goal of end-of-life is improving life quality instead of prolonging life for as long as possible. The effort put into prolonging life for as long as possible in the terminally ill often results in extending the patients' suffering, at the same time consuming a lot of medical resources, but the processes are often futile.The goal of palliative care is to improve the quality of life of patients facing life-threatening illness and their families. The approach includes the prevention and relief of pain and other physical symptoms, psychosocial and spiritual suffering since the diagnosis of the disease. Our experiences and current literature indicate that palliative care during end-of-life indeed improves physical symptoms as well as emotional distress, decreases the fear for death by strengthening the inner power, and as a whole improves the quality of life, hence achieving the goal of 'having a good death'.We reviewed current evidence and evaluated the cost effectiveness of palliative care from three dimensions: cost to the patient, cost to the family members and caregivers, and cost to the health care system. The effect evaluations were symptom control, the quality of life, patient and family satisfaction, and the feelings of patients and families facing end-of-life. In conclusion, palliative care is cost-effective and provides good quality of care for those in the end-of-life.
期刊論文
1.Leung, K. K.、Chiu, T. Y.、Chen, C. Y.(2006)。The influence of awareness of terminal condition on spiritual well-being in terminal cancer patients。J Pain Symptom Manage,31,449-456。  new window
2.釋宗惇、釋德嘉、陳慶餘、釋宏琳、釋印本、釋印適、釋德俅、釋慧岳、釋惠敏(20060500)。安寧緩和醫療之死亡準備。安寧療護,11(2),117-136。new window  延伸查詢new window
3.Taylor, D. H. Jr.、Ostermann, J.、Van Houtven, C. H.、Tulsky, J. A.、Steinhauser, K.(2007)。What length of hospice use maximizes reduction in medical expenditures near death in the US Medicare program?。Social Science & Medicine,65(7),1466-1478。  new window
4.Lin, Wen-yuan、Chiu, Tai-yuan、Hsu, Hua-shai、Davidson, Lance E.、Lin, Tsann、Cheng, Kao-chi、Chiu, Chang-fang、Li, Chia-ing、Chiu, Yi-wen、Lin, Cheng-chieh、Liu, Chiu-shong(20091000)。Medical Expenditure and Family Satisfaction between Hospice and General Care in Terminal Cancer Patients in Taiwan。Journal of the Formosan Medical Association,108(10),794-802。  new window
5.Temel, Jennifer S.、Greer, J. A.、Muzikansky, A.、Gallagher, E. R.、Admane, S.、Jackson, V. A.、Lynch, T. J.(2010)。Early palliative care for patients with metastatic non-small-cell lung cancer。The New England Journal of Medicine,363(8),733-742。  new window
6.Lo, J. C.(2002)。The impact of hospices on health care expenditures- the case of Taiwan。Social Science & Medicine,54(6),981-991。  new window
7.Tsai, J. S.、Wu, C. H.、Chiu, T. Y.、Hu, W. Y.、Chen, C. Y.(2005)。Fear of death and good death among the young and elderly with terminal cancers in Taiwan。Journal of pain and symptom management,29(4),344-351。  new window
8.Higginson, I. J.、Finlay, I. G.、Goodwin, D. M.、Hood, K.、Edwards, A. G. K.、Cook, A.、Douglas, H. R.、Normand, C. E.(2003)。Is there evidence that palliative care teams alter end-of-life experiences of patients and their caregivers?。Journal of Pain and Symptom Management,25(2),150-168。  new window
9.Prendergast, T. J.(2001)。Advance care planning: Pitfalls, progress, promise。Critical Care Medicine,29(2),34-39。  new window
10.McMillan, S. C.(1996)。The quality of life of patients with cancer receiving hospice care。Oncology Nursing Forum,23(8),1221-1228。  new window
其他
1.World Health Organization。WHO Definition of Palliative Care,http://www.who.int/cancer/palliative/definition/en/, 2010/05/12。  new window
2.Robinson, B. E. ; Pham, H.(1996)。Cost- effectiveness of hospice care。  new window
3.Barnato, A. E. ; McClellan, M. B. ; Kagay, C. R. ; Garber, A. M.(2004)。Trends in inpatient treatment intensity among Medicare beneficiaries at the end of life。  new window
4.Emanuel, E. J. ; Ash, A. ; Yu, W.(2002)。Managed care, hospice use, site of death, and medical expenditures in the last year of life。  new window
5.Pronovost, P. ; Angus, D. C.(2001)。Economics of end-of-life care in the intensive care unit。  new window
6.Devader, T. E. ; Albrecht, R. ; Reiter, M.(2011)。Initiating Palliative Care in the Emergency Department。  new window
7.Giacomini, M. ; Cook, D. ; DeJean, D. ; Shaw, R. ; Gedge, E.(2006)。Decision tools for life support: a review and policy analysis。  new window
8.Singer, P. A. ; Barker, G. ; Bowman, K. W.(2001)。Hospital policy on appropriate use of life-sustaining treatment. University of Toronto Joint Centre for Bioethics/ Critical Care Medicine Program Task Force。  new window
9.Covinsky, K. E. ; Goldman, L. ; Cook, E. F.(1994)。The impact of serious illness on patients' families。  new window
10.World Health Organization(WHO)。Cancer control: knowledge into action: WHO guide for effective programs: palliative care。  new window
11.Christakis, N. A. ; Iwashyna, T. J.(2003)。The health impact of health care on families: a matched cohort study of hospice use by decedents and mortality outcomes in surviving, widowed spouses。  new window
12.Emanuel, E. J.(1996)。Cost savings at the end of life: what do the data show?。  new window
13.Miller, G. W. ; Williams, J. R. ; English, D. J. ; Keyserling, J.(2002)。Delivering Quality Care and Cost-Effectiveness at the End of Life: Building on the 20-Year Success of the Medicare Hospice Benefit。  new window
14.Wright, A. A. ; Zhang, B. ; Ray, A.(2008)。Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment。  new window
15.Singer, P. A. ; Lowy, F. H.(1992)。Rationing, patient preferences and cost of care at the end of life。  new window
16.Baohui, Z. ; Alexi, A. W. ; Haiden, A.(2009)。Health care costs in the last week of life- associations with end-of-life conversations。  new window
17.Movsas, B. ; Moughan, J. ; Sarna, L.(2009)。Quality of life supersedes the classic prognosticators for long-term survival in locally advanced non-small-cell lung cancer: an analysis of RTOG 9801。  new window
18.Pirl, W. F. ; Temel, J. S. ; Billings, A.(2008)。Depression after diagnosis of advanced non-small cell lung cancer and survival: a pilot study。  new window
19.Tu, M. S.(2006)。Illness: an opportunity for spiritual growth。  new window
 
 
 
 
第一頁 上一頁 下一頁 最後一頁 top
:::
無相關博士論文
 
無相關書籍
 
無相關著作
 
QR Code
QRCODE