The Medical Needs and Characteristics of Cancer and Progressive Neurologic Disease Patients Who Use Home-Based Medical Care in Korea: A Retrospective Study for 2011-2020 |
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| Institution: | 1. Public Healthcare Center, Seoul National University Hospital, Seoul, Republic of Korea;2. Department of Family Medicine, Seoul National University Hospital, Seoul, Republic of Korea;3. Center for Palliative care and Clinical Ethics, Seoul National University Hospital, Seoul, Republic of Korea;4. College of Medicine, Seoul National University, Seoul, Republic of Korea;5. Department of Pediatrics, Seoul National University Hospital, Seoul, Republic of Korea;1. Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong;2. Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong;3. Jockey Club Center for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong;1. Department of Epidemiology and Health Systems, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland;2. Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland;1. Department of Geriatrics, Getafe University Hospital, Getafe, Madrid, Spain;2. Department of Medicine and Public Health, Rey Juan Carlos University, Alcorcon, Spain;3. CIBERFES: CIBER''s thematic area for Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain;4. Biomedical Research Foundation of the Getafe University Hospital, Getafe, Madrid, Spain;5. Department of Geriatrics, Virgen del Valle Hospital, Toledo, Spain;1. Center for Healthcare Innovation, Wake Forest School of Medicine, Winston-Salem, NC, USA;2. Center for Biomedical Informatics, Wake Forest School of Medicine, Winston-Salem, NC, USA;3. Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, NC, USA;4. Verily Life Sciences, South San Francisco, CA, USA;5. Department of Internal Medicine, Sticht Center for Healthy Aging and Alzheimer''s Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA;1. Hubbard Center for Nursing Research on Aging, University of Rochester, School of Nursing, Rochester, NY, USA;2. University of Rochester Medical Center, Department of Medicine, Rochester, NY, USA;3. Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ, USA;4. University of Rochester Medical Center, Department of Psychiatry, Rochester, NY, USA;5. Division of Geriatrics & Aging, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA;6. St. John Fisher College, Wegmans School of Pharmacy, Rochester, NY, USA;7. Division of Geriatrics, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA;8. Department of Medicine, Vanderbilt University Medical Center, Center for Quality Aging, Nashville, TN, USA;9. Geriatric Research, Education and Clinical Center (GRECC), VA Tennessee Valley Healthcare System, Nashville, TN, USA;10. Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA;11. Department of Medicine, Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY, USA;12. University of Rochester Medical Home Care, University of Rochester Medical Center, Rochester, NY, USA;13. Finger Lakes Geriatric Education Center, University of Rochester Medical Center, Rochester, NY, USA;1. Health Unit, RAND Corporation, Santa Monica, CA, USA;2. Center for Health Policy, Columbia University School of Nursing, New York, NY, USA;3. Health Unit, RAND Corporation, Boston, MA, USA |
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| Abstract: | ObjectivesTo investigate the needs and characteristics of patients with cancer and neurologic disorders requiring home-based medical care (HBMC).DesignRetrospective observational study.Setting and ParticipantsPatients receiving HBMC on discharge from a tertiary hospital in Korea during 2011-2020.MethodsPatients were classified into 3 disease groups: cancer, progressive neurologic disorders (NR), and others. Characteristics and medical needs were assessed in each disease group. Medical needs were categorized based on functional items requiring support or management at the time of registration: respiratory, feeding, urinary system, drain tube, central catheter, wound, medication, and other. Patients with multiple medical needs were assigned to multiple categories. Patients who used HBMC for more than 3 months were defined as long-term users; their characteristics were evaluated in the same way.ResultsOf the total 655 patients, 47.0% (308) had cancer and 17.3% (113) were NR patients. Among all patients, 78.8% were partially dependent (44.0%) or completely dependent (34.8%) in daily activities, and there were more dependent patients in the NR group (80.5%) than cancer (26.6%). Patients with cancer needed central catheter management the most (43.5%), followed by wound care (36.7%), feeding support (35.1%), and drain tube management (22.1%). NR patients required feeding support the most (80.5%), followed by respiratory support (43.4%), wound care (41.6%), and urinary system support (19.5%). Of all patients, 30.2% (198) were long-term users (NR, 37.9%; cancer, 35.4%). Long-term users were common among patients who needed respiratory support (59.4%), feeding support (48.75), and urinary system support (34.6%).Conclusions and ImplicationsHomebound patients with cancer and progressive neurologic disorders need medical services at home after discharge. Patients who need feeding and respiratory support usually use HBMC for more than 3 months. Further studies are needed to design an optimal HBMC that continuously provides medical services to patients with serious illnesses living at home. |
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| Keywords: | Home-based medical care home care cancer progressive neurologic condition serious illness |
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