PDF(Pubmed)
Abstract：
UNASSIGNED: The prevalence of end-stage renal disease (ESRD) and the number of patients undergoing dialysis in Taiwan are high. Since September 2009, the National Health Insurance has started to provide hospice care to patients with renal failure in Taiwan. Therefore, it is necessary to understand the use of hospice and nonhospice care in patients with ESRD on dialysis. We aim to understand trends in patients with ESRD receiving hospice and nonhospice care as well as medical care efforts during the last month of their lives (2009-2013).
UNASSIGNED: The cohort study was conducted using 1 million randomly selected samples from the Taiwan Health Insurance Research Database for millions of people in Taiwan in 2009-2013. Descriptive statistics were presented to summarize the characteristics of data. To compare differences between cohorts, Chi-square tests and Student\'s t-tests were used. Mann-Whitney U-tests were performed for nonnormally distributed data. Mantel-Haenszel test was test for trend.
UNASSIGNED: We recruited 770 ESRD patients who underwent hemodialysis; among them, 154 patients received hospice care. Patients who received hospice care had a significantly longer survival time after removal of mechanical ventilator (20 vs. 0 days) and after discontinuation of dialysis (2 vs. 0 days) compared with those who did not receive hospice care. Patients who received hospice care had more pain control (61.04% vs. 17.37%, P < 0.0001) and other symptomatic control (55.84% vs. 43.18% with diuretics, P < 0.05; 64.29% and 48.21% with laxatives, P = 0.0004) medications than those who did not. Nevertheless, the overall medical cost in the hospice group was significantly lower (90 USD and 280 USD, P < 0.0001).
UNASSIGNED: Our results suggest that the addition of hospice care may permit patients a longer life-support-free survival time. In addition, despite a more frequent symptomatic controlling agent use, hospice care significantly reduced the overall medical expenditure.
UNASSIGNED: The cohort study was conducted using 1 million randomly selected samples from the Taiwan Health Insurance Research Database for millions of people in Taiwan in 2009-2013. Descriptive statistics were presented to summarize the characteristics of data. To compare differences between cohorts, Chi-square tests and Student\'s t-tests were used. Mann-Whitney U-tests were performed for nonnormally distributed data. Mantel-Haenszel test was test for trend.
UNASSIGNED: We recruited 770 ESRD patients who underwent hemodialysis; among them, 154 patients received hospice care. Patients who received hospice care had a significantly longer survival time after removal of mechanical ventilator (20 vs. 0 days) and after discontinuation of dialysis (2 vs. 0 days) compared with those who did not receive hospice care. Patients who received hospice care had more pain control (61.04% vs. 17.37%, P < 0.0001) and other symptomatic control (55.84% vs. 43.18% with diuretics, P < 0.05; 64.29% and 48.21% with laxatives, P = 0.0004) medications than those who did not. Nevertheless, the overall medical cost in the hospice group was significantly lower (90 USD and 280 USD, P < 0.0001).
UNASSIGNED: Our results suggest that the addition of hospice care may permit patients a longer life-support-free survival time. In addition, despite a more frequent symptomatic controlling agent use, hospice care significantly reduced the overall medical expenditure.
摘要：
未经证实：台湾终末期肾病（ESRD）的患病率和接受透析的患者数量很高。自2009年9月起，国民健康保险开始为台湾肾衰竭患者提供临终关怀。因此,有必要了解终末期肾病透析患者临终关怀和非临终关怀的使用情况.我们的目标是了解ESRD患者接受临终关怀和非临终关怀护理的趋势，以及他们生命的最后一个月（2009-2013）的医疗护理工作。
UNASSIGNED：该队列研究是使用台湾健康保险研究数据库中2009-2013年为台湾数百万人随机选择的100万个样本进行的。提出了描述性统计数据来总结数据的特征。要比较队列之间的差异，使用卡方检验和学生t检验。对非正态分布数据进行了Mann-WhitneyU检验。Mantel-Haenszel测试是趋势测试。
未经证实：我们招募了770名接受血液透析的ESRD患者；其中，154名患者接受了临终关怀。接受临终关怀的患者在撤除机械呼吸机后的生存时间明显更长（20vs.0天）和停止透析后（2vs.0天）与未接受临终关怀的人相比。接受临终关怀护理的患者疼痛控制更多（61.04%vs.17.37%,P<0.0001）和其他症状控制（55.84%vs.43.18%使用利尿剂，P<0.05;64.29%和48.21%使用泻药,P=0.0004）的药物比没有的药物。然而，临终关怀组的整体医疗费用明显较低(90美元和280美元，P<0.0001)。
UNASSIGNED：我们的结果表明，增加临终关怀可能会延长患者的无生命生存时间。此外,尽管更频繁地使用症状控制剂，临终关怀显著降低了整体医疗支出。
UNASSIGNED：该队列研究是使用台湾健康保险研究数据库中2009-2013年为台湾数百万人随机选择的100万个样本进行的。提出了描述性统计数据来总结数据的特征。要比较队列之间的差异，使用卡方检验和学生t检验。对非正态分布数据进行了Mann-WhitneyU检验。Mantel-Haenszel测试是趋势测试。
未经证实：我们招募了770名接受血液透析的ESRD患者；其中，154名患者接受了临终关怀。接受临终关怀的患者在撤除机械呼吸机后的生存时间明显更长（20vs.0天）和停止透析后（2vs.0天）与未接受临终关怀的人相比。接受临终关怀护理的患者疼痛控制更多（61.04%vs.17.37%,P<0.0001）和其他症状控制（55.84%vs.43.18%使用利尿剂，P<0.05;64.29%和48.21%使用泻药,P=0.0004）的药物比没有的药物。然而，临终关怀组的整体医疗费用明显较低(90美元和280美元，P<0.0001)。
UNASSIGNED：我们的结果表明，增加临终关怀可能会延长患者的无生命生存时间。此外,尽管更频繁地使用症状控制剂，临终关怀显著降低了整体医疗支出。
