Korean J Fam Pract.  2021 Oct;11(5):331-337. 10.21215/kjfp.2021.11.5.331.

Act on Decisions on Life-Sustaining Treatment and Timing of Referral to Hospice

• Ju Hn
• Lee SH
• Kim YJ
• Lee SY
• Lee JG
• Yi YH
• Cho YH
• Tak YJ
• Hwang HR
• Park EJ
• Lee YI

• KMID: 2521436
• DOI: http://doi.org/10.21215/kjfp.2021.11.5.331

Abstract

Background
With the entry in force of the Act on Decisions on Life-Sustaining Treatment on February 4, 2018, the right to self-determination in hospice palliative care has received full legal force. The purpose of this study was to investigate the effects of the law on the referral timing of hospice palliative care by comparing patients before and after enforcement of the law.
Methods
Kaplan-Meier survival analysis was performed on patients admitted to a single National University hospital hospice ward from February 6 to June 30, 2017, and February 4 to June 30, 2018. We also analyzed the predicted lifespan indicators at the time of entering the hospice wards of the two groups through crossover analysis.
Results
The results of the survival analysis showed that patients survived longer after the law entered in force than before, but the difference was not statistically significant (median length of survival 32.00 vs. 37.00, P=0.323). In addition, the number of patients with Eastern Cooperative Oncology Group (ECOG) performance score <3 among the after the law entered in force group was statistically significantly higher, with a statistically significant difference (44 vs. 27, P<0.001). The albumin level was higher in the patient group after the law entered in force (2.93±0.63 vs. 3.2±0.63, P=0.002).
Conclusion
Since the Act on Decisions on Life-Sustaining Treatment entered in force, the time of referral has been advanced, and patients’ performance status and serum albumin level at the time of admission have improved.

Keyword

Hospice; Palliative Care; Advance Directives; Referral and Consultation