Development of Community Health Center-Based Hospice Management Model: Pilot Project at a Community Health Center in Busan

Abstract

Purpose: This study was a part of a drive to develop a community health center-based hospice management model which is concerned with hospice care at a community health care setting and available resources of the local community. Methods: Development of a community health center-based hospice management model involved evaluation of existing hospice-related research, including literature review, and research on hospice facilities at the study site, as well as evaluation of model operation. The latter involved community health center-based hospice test operation, and evaluation of test operation by a research team, including of a nursing professor majoring in hospice care and staffs from a community health center in Busan metropolitan city, regional cancer center, and regional terminal cancer patient medical institute. The study was conducted in the 2008 calendar year. Results: The community health center-based hospice management model provides service linked with local community resources, focusing on the local community health center. Financial and administrative assistance is provided by the regional cancer center, with collaboration from academic health care professionals who guide the operation management. The community health center hospice nurse in consultation with a visiting nurse team registers terminally-ill cancer patients and, after assessment, the hospice team prioritize hospice care during team meeting. Care is delivered by staffs and volunteers. Conclusion: The developed community health center-based hospice operation management model maximally utilizes available community health resources to produce qualitative improvement of regional health and welfare policy through improving the lives of home-based cancer patients and their family who are in medical blind spot. (Korean J Hosp Palliat Care 2010;13:109-119)

Development of a Community-Based Palliative Care Model for Advance Cancer Patients in Public Health Centers in Busan, Korea

“…These teams consisted of a public health center manager, a physician, a palliative nurse, a social worker, a chaplain, and volunteers ( Fig. 2 ) [ 10 ]. Public health center managers had the overall administrative responsibility.…”

“…Two social workers were involved in managing cases to which patients at one of the 16 public health centers had been referred because of the socioeconomic need and the need for support from a palliative nurse ( Fig. 2 ) [ 10 ].…”

“…During the study period, the model development team assembled an early framework for an operating model based on palliative care recipients, service level, labor standards for palliative care teams, personnel education, and consortium establishment [ 10 ]. Busan accepted the model development team’s request for continuous adaptation, development, financial support, and evaluation based on the access of home-based cancer patients to palliative care and the effective use of healthcare resources.…”

Evaluation of Outcomes of the Busan Community-based Palliative Care Project in Korea

“…The project also sought to increase the community's recognition of palliative care through educational and promotional activities [14]. The current project commenced at a PHC in 2009, based on a proposal by two professors specialized in palliative care nursing [3]. In 2013, a pilot project was conducted at six PHCs.…”

“…Because community-based palliative care is expanding to all of Busan, there is a need to evaluate whether such services positively influence palliative care patients' quality of life (QOL). Although the system was developed to improve the QOL of end-of-life patients in a socioeconomically vulnerable class [3], current evidence supporting an overall outcome of the model is insufficient [4,5]. Therefore, an overall evaluation of the outcome of services provided in community and home settings by primary healthcare providers, rather than in hospital settings by palliative care specialists, is needed.…”