当院における緩和ケアセンターの開設が緩和ケアサポート活動実績にもたらした効果

Abstract

The Palliative Care Support Team at Nara Medical University Hospital has provided a clinical consu1tation service since February 2007 that was integrated with a Palliative Care Center (PCC) in May 2009. The framework for establishing the PCC was 1) to open a palliative care outpatient clinic， 2) to design a reservation system that corresponds to the introduction of medical support requests，3) to place nurses certified in palliative care and 4) to co-ordinate support to engage in medical activities. The present study examines the impact of opening the PCC on administrative outcomes for palliative care support activities in a medical university hospital. We compared the hospital medical database from February 2007 to April 2009 (before the PCC opened) with that from May to December 2009 (after the PCC opened). We found that the median number of requests for palliative care support increased from 4.0 to 14.5 per month，ρ＜0.0001，the median consultation interval per patient decreased from 3.7 to 2.5 days，ρ = 0.04 and the ratio of outpatients increased from 2.0% to 46.4%，ρ＜0.0001. The median Palliative Prognostic Index decreased from 5.0 to 3.5，ρ＜.0001. These findings indicate that establishment of the PCC has positively contributed to palliative care support activities by creating easier access to requests，generating more frequent consu1tations and providing earlier intervention by palliative care specialists.