PurposeA feasible palliative care model for advance cancer patients is needed in Korea with its rapidly aging population and corresponding increase in cancer prevalence. This study describes the process involved in the development of a community-based palliative care (CBPC) model implemented originally in a Busan pilot project.Materials and MethodsThe model development included steps I and II of the pilot project, identification of the service types, a survey exploring the community demand for palliative care, construction of an operational infrastructure, and the establishment of a service delivery system. Public health centers (including Busan regional cancer centers, palliative care centers, and social welfare centers) served as the regional hubs in the development of a palliative care model.ResultsThe palliative care project included the provision of palliative care, establishment of a support system for the operations, improvement of personnel capacity, development of an educational and promotional program, and the establishment of an assessment system to improve quality. The operational infrastructure included a service management team, provision teams, and a support team. The Busan Metropolitan City CBPC model was based on the principles of palliative care as well as the characteristics of public health centers that implemented the community health projects.ConclusionThe potential use of the Busan CBPC model in Korea should be explored further through service evaluations.

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This study aimed to evaluate the outcomes of a community-based palliative care project conducted in Busan city, Korea, from 2013 to 2015. Methods: We selected four outcome indices based on the project's outcomes derived from a logic model and used a longitudinal and cross-sectional comparative design approach depending on the outcome index. Results: The utilization rate of palliative care increased from 9.2% in 2012 to 41.9% in 2015. Regarding symptom changes in 65 patients receiving palliative care at 3 and 6 months (mean age ¼ 72 years, standard deviation ¼ 9.64, 55.4% women), pain, anxiety, and depression had improved. Quality of life was higher among palliative care patients compared with patients who did not receive palliative care (t ¼ 2.09, p ¼ .039). Regarding recognition of palliative care, civil servants at public health centers who participated in the pilot project (2013e2014) scored higher than those at public health centers who began participation in 2015 (t ¼ 2.67, p ¼ .008). Conclusion: This is the first study in Korea that systematically evaluated community-based palliative care. The Busan Community-based Palliative Care Project improved the quality of life of palliative care patients by providing services at an appropriate level and by raising the recognition of palliative care in the community. To increase the utilization ratio of palliative care and the quality of service, strategies should be developed to supplement medical support systems.

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