| Project/Area Number |
61480174
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
公衆衛生学
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| Research Institution | Teikyo University |
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Principal Investigator |
OHI Gen Dep. of Public Health, Teikyo Univ. School of Med. Professor, 医学部, 教授 (70114410)
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| Co-Investigator(Kenkyū-buntansha) |
HIRANO Wataru Dep. of Public Health, Teikyo Univ. School of Med. Instructor, 医学部, 助手 (10199086)
URANO Naoko Dep. of Public Health, Teikyo Univ. School of Med. Instructor, 医学部, 助手 (30177232)
KOBAYASHI Yasuki Dep. of Public Health, Teikyo Univ. School of Med. Instructor, 医学部, 助手 (70178341)
KAI Ichiro Dep. of Public Health, Teikyo Univ. School of Med. Ass. Professor, 医学部, 講師 (30126023)
YANO Eiji Dep. of Public Health, Teikyo Univ. School of Med. Ass. Professor, 医学部, 助教授 (50114690)
山岡 和枝 帝京大学, 法学部, 講師 (50091038)
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| Project Period (FY) |
1986 – 1988
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| Project Status |
Completed (Fiscal Year 1988)
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| Budget Amount *help |
¥5,300,000 (Direct Cost: ¥5,300,000)
Fiscal Year 1988: ¥1,500,000 (Direct Cost: ¥1,500,000)
Fiscal Year 1987: ¥2,500,000 (Direct Cost: ¥2,500,000)
Fiscal Year 1986: ¥1,300,000 (Direct Cost: ¥1,300,000)
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| Keywords | Terminal Care / Truth-telling / Place of Death / Care Strategy / 医療方針の選択 / 意思疎通 / 在宅医療 / 医療経済的分析 / 意志疎通 / 意思決定 / オートノミー / 知力低下 / 医師・患者関係 / 在宅介護 / 意志決定 / 医師患者関係 |
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| Research Abstract |
We explored tha preferences of patients and attitudes of medical staffs regarding terminal care. The costs of home care and hospital care of terminally ill patients were also analyzed.
Questionnaire studies conducted in 3 areas revealed that:
1. The mojority of respondents wanted a candid talk about their diseases. They also desired to be cared at home, and preferred palliative treatment to life-prolonging treatment.
2. Few physicians would tell cancer patients their diagnoses even when patients requested truth-telling. When patients didn't wish to resuscitate, the majority of physicians would follow patients' desires.
3. Few physicians could estimate their patients' preferences as to information about diseases, place of care, choice of treatment. Physicians also seldom asked patients' preferences.
Further study is needed to see what would enable physicians to give candid talk to patients about diagnosis and prognosis of their diseases and to establish good communication with patients. An economic analysis revealed that:
1. The total costs of hospital care were more than fifteen times greater than that of home care.
2. The per diem costs of hospital care were also higher and increased toward the last month, while the costs of home care remained low.
3. The cost inflation of hospital care was due to resource intensive treatment including both diagnostic and therapeutic services. With home care, the fee of physicians' visits increased around the last month while that of medication decreased. It would be advisable to analyze the cost effectiveness of hospital care in terms of the patients' quality of life, also to analyze the psychological and financial burden of the families.
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