緩和ケアと医学

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Prevalence of Coding Z515 Diagnosis in Cancer Patients and Relationship between Treatment and Cost in Songklanagarind Hospital, Hat Yai, Songkhla

Orapan Fumaneeshoat

Introduction: Code Z515, which indicates palliative care, is a part of the International Classification of Diseases and Related Health Problems (ICD). At present, this diagnostic code is still rarely used although the number of patients requiring palliative care is increasing. So many patients forfeit their right to access the best palliative care and all that it entails.

Objectives: To determine the prevalence of the code Z515 diagnostis according to ICD-10 in patients diagnosed with cancer as well as the relationship between treatment and costs in Songklanagarind Hospital.

Methods: A retrospective descriptive study on patients diagnosed with code Z515 in Songklanagarind Hospital between 2012 and 2016 was conducted. We collected data from our hospital information system (HIS) and divided into 2 groups, In and outpatients department. Then we recorded data using extraction forms. We analyzed the data using percentages, 95% CI and odds ratios.

Results: Prevalence of diagnosis with code Z515 in cancer patients was 1.7 × 10-3 for both in- and outpatients. For outpatients, patients who received radiation and combined treatment were 9.4 and 26.5 times, respectively, to incur medical costs in the range of 4,001 to 6,000 THB (118-177 USD) compared with patients who received supportive treatment or had no cost. The results shows no relationship between the number of medications taken and cost among inpatients, there was no observable difference in statistical significance The same was true for the relationship between treatment and costs as well.

Conclusion: Study found a very low prevalence of coding Z515 use. Although we know that all cancer patients should receive the best palliative care, the greater their benefit from this type of treatment, the Z515 diagnosis remains less pervasive than it should be.