Home-Based Hospice Care Provided by a Free-Standing Hospice Center: Patients' Characteristics and Service Conditions

Kim, Hyoung Suk; June, Kyung Ja; Son, Young Sun

Abstract

PURPOSE
This study was conducted to investigate patients' characteristics and actual conditions of home-based services offered by a free-standing hospice center.
METHODS
A retrospective review was performed with the medical records of 75 patients who received home-based hospice care from a free-standing hospice center from January 2014 through December 2014.
RESULTS
Most patients (54.7%) were enrolled via self-directed referral. The reason for the service termination was death at home 25.3%, admission to a hospice ward 50.7%, hospitalization 22.6% and patients' refusal 2.7%. Seventy three patients had cancer, and two patients had ALS. Among all, 58.7% were in a dying phase, and 34.7% were almost completely bedfast at the time of their enrollment in this study. When they enrolled, the patients' physical symptoms were characterized as pain (89.4%), sleep disturbance (71.2%), urinary difficulties (35.8%) and defecation difficulties (47.8%). Among all, 77.4% terminated the home visit service within one month. The mean frequency of the home visits was 3.25 (±3.98), and less than five in 82.7% of patients. The mean frequency of the phone service was 3.40 (±3.12). The frequency of doctor's home visits was 1.21±0.79 on average, and the figure increased when patients' conditions turned unstable.
CONCLUSION
It is necessary to develop a home-based hospice care model with consideration of patients' characteristics and the actual service conditions delivered by free-standing hospice facilities.