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KMID : 1039620210110050331
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Korean Journal of Family Practice
2021 Volume.11 No. 5 p.331 ~ p.337
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Act on Decisions on Life-Sustaining Treatment and Timing of Referral to Hospice
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Ju Han-Na
Lee Seung-Hun
Kim Yun-Jin
Lee Sang-Yeoup
Lee Jeong-Gyu
Yi Yu-Hyeon
Cho Young-Hye
Tak Young-Jin
Hwang Hye-Rim
Park Eun-Ju
Lee Young-In
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Abstract
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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 hospicepalliative care has received full legal force. The purpose of this study was to investigate the effects of the law on the referral timing of hospicepalliative 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 toJune 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 thetwo 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 notstatistically significant (median length of survival 32.00 vs. 37.00, P=0.323). In addition, the number of patients with Eastern Cooperative OncologyGroup (ECOG) performance score <3 among the after the law entered in force group was statistically significantly higher, with a statisticallysignificant 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’ performancestatus and serum albumin level at the time of admission have improved.
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KEYWORD
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Hospice, Palliative Care, Advance Directives, Referral and Consultation
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