• J Pain Symptom Manage · Sep 2020

    Impact of the COVID-19 Pandemic on the Utilization of Hospice Care Services: A Cohort Study in Taiwan.

    • Yi-Chang Chou, Yung-Feng Yen, Rung-Chuang Feng, Meng-Ping Wu, Ya-Ling Lee, Dachen Chu, Sheng-Jean Huang, Curtis J Randall JR Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, USA; Cambia Palliative Care Center of Excellence, Univers, and Hsiao-Yun Hu.
    • Department of Education and Research, Taipei City Hospital, Taipei, Taiwan; Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
    • J Pain Symptom Manage. 2020 Sep 1; 60 (3): e1-e6.

    ContextHospice care focuses on improving the quality of end-of-life care and respecting patients' preferences regarding end-of-life treatment. The impact of coronavirus disease 2019 (COVID-19) on the utilization of hospice services is unknown.ObjectivesTo investigate the utilization of hospice care services before and during the COVID-19 pandemic.MethodsAll patients (n = 19,900) cared for at Taipei City Hospital from January 2019 to April 2020 were divided into three time points: January-April 2019 (before COVID-19), May-December 2019 (interim), and January-April 2020 (during COVID-19). This cohort study compared the monthly utilization of hospice services before and during the COVID-19 pandemic.ResultsThere was no significant difference in hospice home visits (194 vs. 184; P = 0.686) and new enrollments (15 vs. 14; P = 0.743) to hospice home care before and during the pandemic. However, the bed occupancy rate in hospice units in the hospital was significantly reduced from 66.2% before the pandemic to 37.4% during the pandemic (P = 0.029), whereas that in nonhospice units had a nonsignificant decrease from 81.6% before the pandemic to 71.8% during the pandemic (P = 0.086). During the pandemic, the number of inpatient days was affected more severely in hospice units than in nonhospice units (-42.4% vs. -10.9%; P = 0.029).ConclusionsThis study suggests that hospice home care services were maintained during the COVID-19 pandemic, while the utilization of hospice inpatient care services reduced. Home care for hospice patients is an essential component of palliative care during a pandemic.Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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