研究發現，臨終關懷在美國和加拿大各不相同
End-of-life care for older people with advanced lung cancer differs in the United States and in the Canadian province of Ontario, a new study says.
一項新的研究發現，美國和加拿大安大略省對患有晚期肺癌的老年人的臨終關懷各不相同。
U.S. patients receive far more chemotherapy, while patients in Ontario make much more use of hospital and emergency room services, according to the analysis of data from the U.S. government and the Ontario Cancer Registry. The information was collected from people 65 and older who died from non-small-cell lung cancer between 1999 and 2003.
根據美國政府和安大略省癌症登記處的數據分析，美國患者接受更多的是化療，而安大略省患者更多的是採取醫院和急診室救護設備。這些信息是從1999-2003年裏65歲及以上因患非小細胞肺癌死亡的患者那裏收集到的。
Health-care services were used extensively by patients in both countries, particularly in the last month of life. More than twice as many people in Ontario died in a hospital, even though most patients in Ontario have said they want to die at home, the study reported.
醫療保健設施在兩個國家都被廣泛應用，尤其是在生命中的最後一個月。在安大略省兩倍以上的病人死於醫院，儘管他們當中大部分人表示希望死在家裏，研究報道。
Elderly people in both the United States and Canada receive government-financed health care, but there are differences in end-of-life coverage. In the United States, hospice care for qualified patients is covered by Medicare. Ontario has no hospice program comparable to what's available in the United States, but the province provides palliative care through hospital acute-care units, outpatient services and home health care.
美國和加拿大的老年人受到政府集資的醫療保健，但是他們的臨終關懷覆蓋率不同。在美國，實行臨終關懷的合格病人是由美國醫療保健計劃所包括的。而在安大略省，沒有臨終關懷計劃比美國的更有效，不過他們對醫院急診病房，門診病人服務和家庭保健提供緩和療法。
According to the researchers, lack of hospice services in Canada contributes to Ontario's higher rates of hospital and emergency room visits and in-hospital deaths.
根據研究人員所說，加拿大缺少臨終關懷導致安大略省醫院病房和急診室病人較多，而且在醫院裏死亡的人數也更多。
The findings, published online May 18 in the Journal of the National Cancer Institute, could help show health planners and policy makers where changes in practices or programs could improve care for dying patients, the researchers said.
5月18日網上發表在《美國國家癌症研究所雜誌》上的調查結果幫助表明健康規劃者和決策者在實踐或理論上的改變可以改善對臨終病人的關懷，研究人員稱。
End-of-life care also varies from region to region in the United States and Canada, Dr. David Goodman, of the Dartmouth Institute for Health Policy and Clinical Practice, wrote in an accompanying journal editorial.
臨終關懷在美國和加拿大各個地區也各有不同，達特茅斯衛生政策與臨牀診療研究所的大衛•古德曼博士在附帶的雜誌評論中寫道。
In addition, patient preferences vary from person to person, and these preferences often go unheard, he said. The best type of end-of-life care, Goodman said, involves the patient in the decision making.
此外，病人的選擇權也因人而異，而這些選擇權經常不予理睬。古德曼說，最好的臨終關懷類型需加入病人的決定。
