A trial of appropriate and fair management of hospitalization to palliative care unit
10.2512/jspm.10.917
- VernacularTitle:緩和ケア病棟の入院判定の適正化，公正化の試み―入院必要度のスコア化のためのチェックリストの導入―
- Author:
Michio Kimoto
;
Norifumi Kishimoto
;
Hiromi Nishi
- Publication Type:Journal Article
- Keywords:
palliative care unit;
management of hospitalization;
criterion for judgment;
checklist
- From:Palliative Care Research
2015;10(1):917-921
- CountryJapan
- Language:Japanese
-
Abstract:
Compared with the increase of cancer patients, there is insufficiency number of beds at palliative care unit(abbreviated to PCU)and hospice. To utilize them as medical resource efficiently, it is necessary to assess the condition of patients and to decide the order of admission fairly and impartially. The appropriate way of decision is also a prerequisite of the facility criterion of hospice by the Ministry of Health, Labour and Welfare and one of the evaluation items of palliative care by Japan Council for Quality Health Care. Many PCUs and hospices declare that a conference for the hospitalization judgment is held regularly, although few hospitals disclose the process of decision and its criteria of the order of priority. We made a checklist for the judgment of hospice admission in which the needs of hospitalization are converted to the numerical value in terms of patient's willingness, condition, context and prognosis. The checklist was introduced in our PCU in September 2012. In 2013 fiscal year, the conference for the judgment of PCU admission was held almost once a week(51 times)and the total number discussed were 403 cases(7.9 cases per one conference)and those who were actually hospitalized were 187 patients. The imbalance shows the necessity of the fair and impartial decision.
