Page 74 - 2019-安寧專刊

Hospice palliative care services across Taiwan

Where are the hospice palliative care teams?
Inspired by the work of “Hospice Palliative care units in Japan, current status and perspectives” published by the Japanese pioneers in 2001, we started to collected the year-to-year changes of numbers of hospice palliative care units and of in-patient beds available for patients. As shown in Fig 1.
2019, the TAHPM welcomes its first 20th anniversary. Reviewing the longitudinal data collected, it helps in more detail understanding of the changes in number and distribution of hospice palliative care teams, especially in comparison with the population or death statistics; and furthermore, it raises awareness of the possible gap between the needs and supply of palliative care in the community.
Current In-patient hospice wards, the base for palliative care teams
New hospice wards were opened every year, others expanded their number of beds available; however, there were times when beds numbers were cut less and wards were closed. (Fig.2) As a
trend, the numbers of hospice wards and beds increase substantially over the past 30 years, and up to the end of March 2019, there are 76 hospices, all hospital- based, with 819 beds. There are around 6 to 20 beds in most hospice wards(Table 1). During 2000~2009, the average size of a hospice ward were around 15 to 16 beds. But in recent decade, the size decreased steadily and now the average size is 10.8 bed in a ward, with the median at 10. (Fig. 3)This means that half of hospices now accommodate 10 patients or less at one time.
As for the different founding backgrounds, nearly half of the hospice wards, and 43% of hospice beds, are in public hospitals. They include the affiliated hospitals of national universities
(6units, 65 beds), MOHW hospitals(16 units, 115 beds) and veteran hospitals (9 units, 107 beds). In hospitals with religious background, they accommodate 21% of units and 25% of beds.(Table 1)
Almost 60% of units and 55% of beds are in the regional / secondary referral hospitals; while only 22% of units are in tertiary referral centers, they accommodate 1/3 of beds.
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Chapter 3
成長主題