Survey on quality of end-of-life care and place of death by using nationwide administrative data
| Project/Area Number |
18H03082
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Review Section |
Basic Section 58060:Clinical nursing-related
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| Research Institution | Nagoya University |
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Principal Investigator |
Sato Kazuki 名古屋大学, 医学系研究科(保健), 准教授 (60583789)
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| Co-Investigator(Kenkyū-buntansha) |
宮下 光令 東北大学, 医学系研究科, 教授 (90301142)
坂下 明大 神戸大学, 医学部附属病院, 医学研究員 (90514662)
田辺 公一 名城大学, 薬学部, 准教授 (30709704)
安藤 詳子 名古屋大学, 医学系研究科(保健), 教授 (60212669)
杉田 豊子 名古屋大学, 医学系研究科(保健), 助教 (10454373)
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| Project Period (FY) |
2018-04-01 – 2021-03-31
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| Project Status |
Completed (Fiscal Year 2021)
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| Budget Amount *help |
¥14,820,000 (Direct Cost: ¥11,400,000、Indirect Cost: ¥3,420,000)
Fiscal Year 2020: ¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000)
Fiscal Year 2019: ¥4,940,000 (Direct Cost: ¥3,800,000、Indirect Cost: ¥1,140,000)
Fiscal Year 2018: ¥5,460,000 (Direct Cost: ¥4,200,000、Indirect Cost: ¥1,260,000)
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| Keywords | 緩和ケア / 終末期医療 / 医療の質 / 実態調査 / ビッグデータ / 延命治療 / 非がん疾患 / 療養場所 / 悪性腫瘍 / 非がん / 疫学調査 |
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| Outline of Final Research Achievements |
We clarified the actual conditions of terminal care and life of non-cancer patients in Japan from NDB sampling dataset and vital statistics. The high level of life-prolonging treatment administered at the end of life of a chronic disease is considered excessive medical care. Life-prolonging treatment was more common for non-cancer diseases compared to cancer. This was particularly common in heart failure, but the mix of acute and chronic disease was a challenge in the evaluation. Palliative treatment was very infrequent outside of cancer. Home deaths show no upward trend for any cause of death other than cancer. Analysis by medical region also showed that only a few medical regions showed an increase in home deaths for causes of death other than cancer.
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| Academic Significance and Societal Importance of the Research Achievements |
高齢多死社会を迎え、終末期医療の質の保障は重要な課題である。本邦では緩和ケアはがん医療を中心に発展し、非がん疾患での終末期ケアが特に課題となる。医療ビッグデータであるレセプトや死亡診断書の情報を研究目的で活用し、非がん終末期ケアの実態を明らかにした。がんと比較して非がん疾患では終末期に、過剰な延命治療が多く、症状緩和治療は少ないこと、自宅死亡はがんのみで増加傾向であることが明らかとなった。なお、慢性疾患終末期の延命治療は予後延長効果に比して苦痛が多く推奨されず、終末期の自宅療養は多くの国民の希望である。
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Report
(4 results)
Research Products
(17 results)
