Real State of the Terminal Care of Lung Cancer in the Integrated Community Care System after Medical Fees Revision 2018

Abstract

Abstract Background After Medical Fees Revision FY2018, movements from Integrated Community Care Ward(IW) to Long-term Treatment Ward(LW) are not regarded as going home, but we foresaw in the last annual meeting that the Integrated Community Care System(IS) might still function well in the terminal care of lung cancer if home care system and LW were effective. So we verify the predict by examining our additional practice over the last year. Methods We investigated medical records of 164 dead lung cancer patients treated in Tokyo Kensei Hospital(THp) (35 IW beds, 64 LW beds) and Ooizumi Health Cooperative Hospital(OHp) (47 IW beds, and 47 acute ward beds) in the last 6 years, and checked the state of cooperation between hospitals and clinics, the places of death. Results 41 of 66 THp patients passed away in LW, and 12 in IW. Such cases are still increasing due to introduction for BSC from acute hospitals. In FY2018 we saw a lung cancer patient who enjoyed the terminal care under the cooperation among acute hospital, IW, home care system, and LW (case presentation). In OHp no patients move to hospice or LW in FY2018, 32 (with 3 additional) cases of 98 patients passed away at home, and 8 (with 5 additional at one year) cases died in IW. Since FY2015 when IWs were opened in both hospitals, 1632 patients of all diseases stayed 28.4 days on average at IW in THp, and 1995 patients 29.4 days in OHp, significantly longer (P Conclusion After revision 2018, definition of going home has been more strict, but we recognize that IS where IW centers actually functions well under the close cooperation with home care or LW.