Effects of advanced care planning on end-of-life care in Lamphun Hospital

Abstract

Abstract

Currently, the number of end-of-life patients has increased. Although patients in this group received full treatment, there was still both physical and mental suffering. The complex problems caused by a variety of factors, both from the patients themselves and their families. End-of-life patients should receive palliative care and discuss advanced care plans, focus on what they need and their goals of care at different stages of life. This study was a retrospective cohort study, studying the effects of advanced care planning among cancer and non-cancer patients in the advanced stage of their illness who were treated at Lamphun Hospital and died between October 2021 and September 2022, for invasive procedures at the end of life, place of death, length of stay and cost of health care in-hospital. The population was 394 people, who were corrected and analyzed using Chi Square and a t-test comparing invasive procedures (ET intubation, CPR) at the end of life, place of death, length of stay and cost of health care in-hospital treatment between those with an advanced care plan group and those with no advanced care plan. The results of the study revealed that the patients with an advanced care plan reported less invasive procedures at the end of life, such as endotracheal intubation before death (1.83%), and lower cardiopulmonary compression before death 0% (p<0.01), and the proportion of deaths at home were 66.97%. (p<0.01). The length of stay was 7.81 days and the cost of in-hospital health care was 47,343.09 Baht, significantly lower than the patients who did not have an advanced care plan (p=0.02 and p<0.01, respectively).