Institutions | About Us | Help | Gaeilge
rian logo


Mark
Go Back
Place of care: from referral to specialist palliative care until death.
O'Leary, Mary Jane; O'Brien, Alison C; Murphy, Marie; Crowley, Claire M; Leahy, Helen M; McCarthy, Jill M; Collins, Joan C; O'Brien, Tony
Background: While there are many poorly standardised studies focusing on place of death, there are limited data on place(s) of care during the final stages of disease. AIM: This study aims to identify where patients are cared for in the interval from referral to specialist palliative care until death. METHODS: All patients who died while under the care of a specialist palliative care service over a 6-month period were considered. RESULTS: Of the 507 patients included, 255 (50.3%) were men and 428 (84.4%) had a malignant diagnosis. The mean referral-to-death interval was 70 days (SD 113, Range 1-838). The majority (n=281, 55.4%) received care in a single care setting-hospital (28.4%), home (21.5%), nursing home/community hospital (4.1%), hospice (1.4%)-and had a shorter mean referral-to-death interval. Most patients with more than one care setting spent three-quarters of their time in their normal place of residence. A total of 199 (39.3%) died in hospital, 131 (25.8%) in hospice, 131 (25.8%) at home (25.8%) and 46 (9.1%) in a nursing home/community hospital. Patients referred by a general practitioner (n=80 patients, 15.8%) were more likely to be cared for at home (p<0.001), and die at home (p<0.001). CONCLUSIONS: A significant number of patients received specialist palliative care across multiple care settings. Late referral is associated with a single domain of care. General practitioner involvement supports patient care and death at home. Place of care and ease of transfer between care settings may be better indicators of the quality of care we provide. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions. While there are many poorly standardised studies focusing on place of death, there are limited data on place(s) of care during the final stages of disease. This study aims to identify where patients are cared for in the interval from referral to specialist palliative care until death. All patients who died while under the care of a specialist palliative care service over a 6-month period were considered. Of the 507 patients included, 255 (50.3%) were men and 428 (84.4%) had a malignant diagnosis. The mean referral-to-death interval was 70 days (SD 113, Range 1-838). The majority (n=281, 55.4%) received care in a single care setting-hospital (28.4%), home (21.5%), nursing home/community hospital (4.1%), hospice (1.4%)-and had a shorter mean referral-to-death interval. Most patients with more than one care setting spent three-quarters of their time in their normal place of residence. A total of 199 (39.3%) died in hospital, 131 (25.8%) in hospice, 131 (25.8%) at home (25.8%) and 46 (9.1%) in a nursing home/community hospital. Patients referred by a general practitioner (n=80 patients, 15.8%) were more likely to be cared for at home (p<0.001), and die at home (p<0.001). A significant number of patients received specialist palliative care across multiple care settings. Late referral is associated with a single domain of care. General practitioner involvement supports patient care and death at home. Place of care and ease of transfer between care settings may be better indicators of the quality of care we provide.
Keyword(s): PALLIATIVE CARE; COMMUNICATION; HOSPICE; HOME CARE
Publication Date:
2014
Type: Journal article
Peer-Reviewed: Unknown
Language(s): English
Institution: Lenus
Publisher(s): BMJ Publishing Group Ltd
Related Link(s): http://spcare.bmj.com/content/early/2012/11/20/bmjspcare-2012-000281
First Indexed: 2016-04-23 07:05:49 Last Updated: 2017-05-12 06:57:11