The National Cancer Center East Hospital established the palliative care unit in 1992, which serves as the only unit providing palliative care services. The main purpose of establishing this unit was to provide end-of-life care to patients with incurable cancer. Approximately 90% of such patients eventually succumb to death in this unit. In outpatient-based chemotherapy, which was managed passively, the management of devastating symptoms was performed in an outpatient setting. This made home care the preferred option of many cancer patients. In order to establish the regional palliative care system, many changes in palliative care services to support patients, their families, as well as family physicians and home visiting nurses providing home care have been carried out.
1. Palliative care unit
This unit is the only designated inpatient setting for palliative care in the Toukatu-Hokubu region. Before 2007, the registry system for admission was adopted and patients were admitted based on the order of their application. This system was abolished because patients with severe symptoms had to wait for several days before they could be admitted. The criteria for admitting patients were therefore changed to ensure optimal use of the limited resource and to provide appropriate care to patients with severe physical symptoms and psychological problems. In 2008, many conferences for discharge planning have been conducted to facilitate communication concerning end-of-life care with family physicians and home visiting nurses.
2. Outpatient clinic
Since 2007, an outpatient clinic for the assessment and management of devastating symptoms of patients has been opened for 5 days a week. The clinic closely cooperates with the Psycho-Oncology Service Division to provide total care of patients and their family members.
● H. Kinoshita ●
| New referrals to outpatient clinic (N = 369; january - december 2008) | N (%) | |
| Age | Mean ± SD (median, range) (yr) | 66.0 ± 10.9 (66, 24-91) |
| Gender | (male/female) | 205/164 |
| Survivors or receiving anticancer therapy | 96 (20.6) | |
| Cancer site | Lung | 85 (23.0) |
| Pancreas | 48 (13.0) | |
| Breast | 36 (9.8) | |
| Head and neck | 27 (7.3) | |
| Colorectal | 23 (6.2) | |
| Liver | 23 (6.2) | |
| Esophagus | 18 (4.9) | |
| Stomach | 17 (4.6) | |
| Others | 92 (24.9) | |
| Admission to PCU (N = 377; january-december 2008) | ||
| N (%) | ||
| Age | Mean ± SD (median, range) (yr) | 66.6 ± 10.3(66, 35-96) |
| Gender | (male/female) | 224/153 |
| Cancer site | Lung | 105 (27.9) |
| Pancreas | 36 (9.5) | |
| Breast | 35 (9.3) | |
| Colorectal | 34 (9.0) | |
| Stomach | 27 (7.2) | |
| Head and neck | 25 (6.6) | |
| Esophagus | 21 (5.6) | |
| Liver | 17 (4.5) | |
| Others | 57 (15.1) | |
| Waiting time for admission | Mean±SD (median, range) (days) | 6.0±6.3 (4, 0-40) |
Table of Contents