Please use this identifier to cite or link to this item: http://scholarbank.nus.edu.sg/handle/10635/121936
Title: AN 11-YEAR STUDY OF HOME HOSPICE SERVICE TRENDS IN SINGAPORE FROM 2000 TO 2010
Authors: BENEDICT JOHN HO CHIAN CHING
Keywords: Palliative Care, End of Life, Home Palliative,
Issue Date: 28-Jul-2015
Citation: BENEDICT JOHN HO CHIAN CHING (2015-07-28). AN 11-YEAR STUDY OF HOME HOSPICE SERVICE TRENDS IN SINGAPORE FROM 2000 TO 2010. ScholarBank@NUS Repository.
Abstract: Introduction: Hospice care is most appropriate when a patient no longer benefits from curative treatment and has limited life expectancy. These patients may suffer from any type of life-limiting illness, including end-stage cancer, end-stage heart disease, end-stage renal failure, AIDS and Alzheimer?s disease, among other illnesses. Patients are managed for their pain and symptoms and home hospice care manages these patients in the comfort of their own home, enabling patients to spend their last days with dignity and have a good quality of life. Aim of study: To describe the home hospice patients at HCA Hospice Care (HHC) Singapore from 2000 to 2010. Description of home care patients in terms of their socio-demographic profile and diagnosis at admission. Methods: We reviewed the Electronic Medical Records of patients admitted into HCA Hospice Care from 2000 to 2010. Results: Patients had multiple admissions into HHC home hospice as identified in the EMR between 1 January 2000 and 31 December 2010 but we will only selected patient?s first admission into HHC for this analysis. Of the 25,065 patients in the entire samples, 47.3% were males, 65.2% were married and 84.3% were Chinese. 50.9% of the patients died at home, 75.5% were referred from public hospitals, 53.9% of primary caregivers were children and the mean age of the patients were 68.0 years. Amongst all cancer patients admitted into HHC, lung cancer (23.6%) was the most common principal diagnosis for admission, followed by colorectal (10.5%) and liver cancers (7.7%). Among non-cancer patients, renal failure (7.0%) was the most common diagnosis. Among male patients admitted into HHC, lung cancer (29.6%) was the most common diagnosis, followed by liver cancer (10.8%), colorectal cancer (10.0%) and end-stage renal failure (5.5%). For female patients, lung cancer (16.9%) was the most common diagnosis, followed by breast cancer (15.9%), colorectal cancer (11.0%) and end-stage renal failure (8.7%). Over the ten year period, HHC admitted between 1971 and 2740 patients; more than 80% (89.9% to 96.2%) of the patients were admitted from public hospitals, more than 60% of the patients are aged 50 years and older, increasing trend of primary decision makers were children (48.8% to 63.3%) and decreasing trend of spouse (32.7% to 22.1%) and increasing trend of the patients are dying at home (28.9% to 39.1%) and decreasing trend of patients dying in the hospitals (71.0% to 46.4%). There is an increasing trend of patients admitted to HHC with gynecological and prostate cancers and advanced renal disease. Compared to patients referred by acute care private providers, patents referred by community providers and private primary care providers is more likely to die within 6 months of admission. Patients who were separated or remained single were more likely to die within 6 months of admission as compared to patients who were married. Ethnicity is significantly associated with death and patients who appointed themselves as primary care decision maker were highly associated with dying within 6 months of admission. Cancer patients were less likely to die within 6 months of admissions as compared to non-cancer patients. Conclusion: In summary, there is an increasing trend of home palliative care referrals and home palliative care patients dying in their own homes from 2000 to 2010. Families, especially children and spouses are important in healthcare decision-making for palliative care patients. Patients with non-cancer diagnoses appear to be an area of underserved need that home hospice services in Singapore need to address.
URI: http://scholarbank.nus.edu.sg/handle/10635/121936
Appears in Collections:Master's Theses (Open)

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