Article type
Year
Abstract
Objective: Health services focus on improving, prolonging and saving lives. The earlier research indicated that end-stage care is inferior to prophylactics or timely care in terms of cost-effective, especially in the end of life. This earlier health technology assessment is to assess therapies for dying patients in terms of effectiveness, safety, ethics and health economics.
Methods: At present, there is no internationally recognized definition of dying patients from the perspective of medicine. Based on related articles and objectives, dying patients referred to the patients who suffer from critical illness/terminal diseases or diseases diagnosed as the end-stage. The therapies for dyingpatients include hospice and critical care. Considering low investment by government and the high cost of health technology including operations, drugs and examinations, more attention was paid to critical care. A comprehensive search of MEDLINE, EMBase, Cochrane Library, Chinese BioMedicine Database (CBM) as well as related online resources was conducted with subject words of "critically illness", "critical care", "intensive care" and "life support care" and limiting data before Dec. 1, 2001.
Results: Few useful studies were identified, especially in dying patients' emergency care. In MEDLINE, nine hundred out of sixty thousand searched articles were clinical trails. Most of them were for end-stage treatment in hospital, such as for unconscious patients (41 studies) and nutritional support (244 studies) and few studies were identified for urgent care. Considering the clinical perspectives and ethics, it is impossible to carry out randomized controlled trials. The alternative was therefore employed, searching databases with sub-subject words such as nosocomial infection, mechanical ventilation, nutritional support and hormone application. Though different from data, all identified trials assess the outcomes with morbidity, disablement, incidence of complication.
Conclusions: It indicated that not all therapies for dying patients were adequate in terms of effectiveness, safety and health economics. Both short-term and long-term outcomes should be taken into account. According to the baseline, assessment of Selective Digestive Tract Decontamination (SDD) is carrying out. Further study of other therapies will be performing. Considering the low quality study in Chinese, it is suggested that health administrations should provide financial support to carry out large-scale retrospective studies and prospective clinical studies when possible.
Methods: At present, there is no internationally recognized definition of dying patients from the perspective of medicine. Based on related articles and objectives, dying patients referred to the patients who suffer from critical illness/terminal diseases or diseases diagnosed as the end-stage. The therapies for dyingpatients include hospice and critical care. Considering low investment by government and the high cost of health technology including operations, drugs and examinations, more attention was paid to critical care. A comprehensive search of MEDLINE, EMBase, Cochrane Library, Chinese BioMedicine Database (CBM) as well as related online resources was conducted with subject words of "critically illness", "critical care", "intensive care" and "life support care" and limiting data before Dec. 1, 2001.
Results: Few useful studies were identified, especially in dying patients' emergency care. In MEDLINE, nine hundred out of sixty thousand searched articles were clinical trails. Most of them were for end-stage treatment in hospital, such as for unconscious patients (41 studies) and nutritional support (244 studies) and few studies were identified for urgent care. Considering the clinical perspectives and ethics, it is impossible to carry out randomized controlled trials. The alternative was therefore employed, searching databases with sub-subject words such as nosocomial infection, mechanical ventilation, nutritional support and hormone application. Though different from data, all identified trials assess the outcomes with morbidity, disablement, incidence of complication.
Conclusions: It indicated that not all therapies for dying patients were adequate in terms of effectiveness, safety and health economics. Both short-term and long-term outcomes should be taken into account. According to the baseline, assessment of Selective Digestive Tract Decontamination (SDD) is carrying out. Further study of other therapies will be performing. Considering the low quality study in Chinese, it is suggested that health administrations should provide financial support to carry out large-scale retrospective studies and prospective clinical studies when possible.