Behavior patterns of health care utilization in terminal cancer patients

ABSTRACT

BACKGROUND: In order to improve the quality of life of dying patients so that they may die with dignity, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care. However, their is no adequate medical service at present. We studied terminal cancer patients'behavior patterns of health care utilization, the problems of caring for the patient, and medical services that bereaved families suggested for terminal cancer patients and their families. METHODS: From 271 patients'families who participated in our hospice program from March 1991 to February 1996, 108 bereaved families whom we able to had been contact were interviewed by three student nurses with a structured questionnaire. RESULTS: The terminal cancer patients received their medical care through admission to hospital(45.4%), outpatient clinic(22.2%), emergency room(16.7%), and oriental medicine(12.0%). But during their terminal phase of the illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alternative medicine care such as intake of mushroom and elm tree. 26 bereaved families(24.1%) pointed out the indifference of the medical team as a problem receiving proper hospital care, and 22 bereaved families(20.4%) emphasized emotional strain of their helplessness with the patient's suffering as a problem of caring for the patient at home. Over 90% of bereaved families from their experience suggested needs of continuous care, hospice care, home care, and 24hr telephone service. CONCLUSIONS: There were inappropriate behavior patterns of health care utilization which resulted in large proportion of terminal cancer patients received alternative medicine never receiving proper medical care. Therefore, there is a need to develop the continuous and comprehensive care for terminal cancer patients and their family, such as hospice.)