Behavior Pattems of Health Care Utilization in Terminal Cancer Patients

Han, Tae Hyung; Cho, Byang Jin; Shin, Baek Hyo

Abstract

BACKGROUND: In order to improve the quality of life of dying patients, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care to die with dignity. However, no adequate medical services are available for these terminal cancer patients. We studied their behavior patterns of health care utilization to understand more of their medical and social needs.
METHODS
We investigated 108 bereaved families through the telephone interview with structured questionnaires. They were randomly selected through the retrospective chart review of the terminal patients who passed away due to cancer.
RESULTS
Most of the terminal cancer patients received their care from proper medical services including admission to hospital (45.4%), outpatient clinic (22.2%), emergency room (16.7%), and oriental medicine (12.0%). But during the terminal phase of their illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alternative natural care. 26 bereaved families (24.1%) pointed out the indifference of medical staff as a problem receiving proper hospital care, and 22 (20.4%) emphasized emotional strain of their helplessness with the patients suffering as a problem of caring at home. Over 90% suggested availability of continuous care, hospice care, home care, and 24 hour telephone service to be improved. CONCLUSIONS: Due to various reasons, adequate medical care is not delivered to the terminal cancer patients in our present medical system. These problems can be approached with the establishment of proper education and medical delivery system. The role of comprehensive medical specialty cannot be overly emphasized to accomplish this most effectively.