Lee SM, et al. J Korean Med Assoc. 2018 Aug;61(8):509-521. https://doi.org/10.5124/jkma.2018.61.8.509

The Korean government has implemented a pilot project that introduces a new type of hospice care program called “Consultative Hospice Care” (COHC) since August 2017. The COHC is a new type of hospice program for terminally ill patients in acute care wards, which is different from the Independent Hospice Unit (IHU) care. This study aimed to compare the characteristics of two groups of hospice patients: COHC care only and both IHU care and COHC groups. Healthcare claim data from 1 April 2018 to 31 March 2020 were retrieved from the HIRA data warehouse system. The main outcome variable was patients receiving COHC only or both COHC and IHU care. The total number of hospice patients was 6482. A multivariate logistic regression analysis was used. Of 6482 hospice care recipients, 3789 (58.5%) received both COHC and IHU care. Those who received both COHC and IHU care were significantly associated with several factors: period from the first evaluation to death (adjusted odds ratio (aOR), 1.026; 95% confidence internal (CI), 1.024–1.029; p < 0.0001), disease severity measured by the Charlson Comorbidity Index (aOR, 1.032; CI, 1.017–1.047; p < 0.0001), consciousness (aOR, 3.654; CI, 3.269–4.085; p < 0.0001), and awareness of end-stage disease (aOR, 1.422; CI, 1.226–1.650; p < 0.0001). The COHC program had a critical role in hospice delivery to terminally ill patients. Policymakers on hospice care need to establish plans that promote efficient hospice care delivery systems.

The Act on Hospice and Palliative Care and Decisions on Life-Sustaining Treatment for Patients at the End of Life (ELDA) was passed by the Korean National Assembly in 2016 and came into effect in 2018. Although the stated purpose of the act is to uphold patient autonomy and dignity in the context of end-of-life (EOL) care, its utilization remains low, with only some 40% of EOL decisions reflecting patients’ direct opinions. This study aims to pinpoint areas for enhancing ELDA by comparing it with similar systems in other countries and gathering expert opinions. To achieve this, we reviewed ELDA, compared it with EOL care systems in Taiwan, Japan, the UK, the US, and Germany, and surveyed Korean medical experts to collect their thoughts on how ELDA might be improved. On this basis, we make several recommendations, including broadening the scope of ELDA, bolstering the role of advance directives, and providing education for healthcare professionals. These recommendations are expected to increase the utilization rate of ELDA and enhance the quality of EOL care in South Korea.

In Cheol Hwang, M.D., Ph.D., Jung Hun Kang, M.D., Ph.D., Won-chul Kim, M.S.W., Ph.D., Jeanno Park, M.D., Ph.D., Hyun Sook Kim, R.N., A.P.N., Ph.D., DaeKyun Kim, M.D., Ph.D. and Kyung Hee Lee, M.D., Ph.D.. J Hosp Palliat Care 2022;25:198-203. https://doi.org/10.14475/jhpc.2022.25.4.198

Hyunok Yun, MPH, Shinyoung Kwon, APN, Ph.D., Jieun Choi, MSW and Dae-kyun Kim, M.D., MPH. J Hosp Palliat Care 2026;29:113-25. https://doi.org/10.14475/jhpc.2026.29.3.113