研究发现，临终关怀在美国和加拿大各不相同

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.

一项新的研究发现，美国和加拿大安大略省对患有晚期肺癌的老年人的临终关怀各不相同。

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.

根据美国政府和安大略省癌症登记处的数据分析，美国患者接受更多的是化疗，而安大略省患者更多的是采取医院和急诊室救护设备。这些信息是从1999-2003年里65岁及以上因患非小细胞肺癌死亡的患者那里收集到的。

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.

医疗保健设施在两个国家都被广泛应用，尤其是在生命中的最后一个月。在安大略省两倍以上的病人死于医院，尽管他们当中大部分人表示希望死在家里，研究报道。

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.

美国和加拿大的老年人受到政府集资的医疗保健，但是他们的临终关怀覆盖率不同。在美国，实行临终关怀的合格病人是由美国医疗保健计划所包括的。而在安大略省，没有临终关怀计划比美国的更有效，不过他们对医院急诊病房，门诊病人服务和家庭保健提供缓和疗法。

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.

根据研究人员所说，加拿大缺少临终关怀导致安大略省医院病房和急诊室病人较多，而且在医院里死亡的人数也更多。

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日网上发表在《美国国家癌症研究所杂志》上的调查结果帮助表明健康规划者和决策者在实践或理论上的改变可以改善对临终病人的关怀，研究人员称。

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.

临终关怀在美国和加拿大各个地区也各有不同，达特茅斯卫生政策与临床诊疗研究所的大卫•古德曼博士在附带的杂志评论中写道。

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，病人的选择权也因人而异，而这些选择权经常不予理睬。古德曼说，最好的临终关怀类型需加入病人的决定。