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Socio-economic determinants for the place of last care: results from the acute palliative care unit of a large comprehensive cancer center in a high-income country in Europe

BACKGROUND AND INTRODUCTION: The place of last care carries importance for patients at the end of life. It is influenced by the realities of the social welfare and healthcare systems, cultural aspects, and symptom burden. This study aims to investigate the place of care trajectories of patients admi...

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Autores principales: Christ, Sebastian M., Hünerwadel, Ellen, Hut, Bigna, Ahmadsei, Maiwand, Matthes, Oliver, Seiler, Annina, Schettle, Markus, Blum, David, Hertler, Caroline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10408184/
https://www.ncbi.nlm.nih.gov/pubmed/37550688
http://dx.doi.org/10.1186/s12904-023-01240-2
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author Christ, Sebastian M.
Hünerwadel, Ellen
Hut, Bigna
Ahmadsei, Maiwand
Matthes, Oliver
Seiler, Annina
Schettle, Markus
Blum, David
Hertler, Caroline
author_facet Christ, Sebastian M.
Hünerwadel, Ellen
Hut, Bigna
Ahmadsei, Maiwand
Matthes, Oliver
Seiler, Annina
Schettle, Markus
Blum, David
Hertler, Caroline
author_sort Christ, Sebastian M.
collection PubMed
description BACKGROUND AND INTRODUCTION: The place of last care carries importance for patients at the end of life. It is influenced by the realities of the social welfare and healthcare systems, cultural aspects, and symptom burden. This study aims to investigate the place of care trajectories of patients admitted to an acute palliative care unit. MATERIALS AND METHODS: The medical records of all patients hospitalized on our acute palliative care unit in 2019 were assessed. Demographic, socio-economic and disease characteristics were recorded. Descriptive and inferential statistics were used to identify determinants for place of last care. RESULTS: A total of 377 patients were included in this study. Median age was 71 (IQR, 59–81) years. Of these patients, 56% (n = 210) were male. The majority of patients was Swiss (80%; n = 300); about 60% (n = 226) reported a Christian confession; and 77% had completed high school or tertiary education. Most patients (80%, n = 300) had a cancer diagnosis. The acute palliative care unit was the place of last care for 54% of patients. Gender, nationality, religion, health insurance, and highest level of completed education were no predictors for place of last care, yet previous outpatient palliative care involvement decreased the odds of dying in a hospital (OR, 0.301; 95% CI, 0.180–0.505; p-value < 0.001). CONCLUSION: More than half of patients admitted for end-of-life care died on the acute palliative care unit. While socio-economic factors did not determine place of last care, previous involvement of outpatient palliative care is a lever to facilitate dying at home. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-023-01240-2.
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spelling pubmed-104081842023-08-09 Socio-economic determinants for the place of last care: results from the acute palliative care unit of a large comprehensive cancer center in a high-income country in Europe Christ, Sebastian M. Hünerwadel, Ellen Hut, Bigna Ahmadsei, Maiwand Matthes, Oliver Seiler, Annina Schettle, Markus Blum, David Hertler, Caroline BMC Palliat Care Research BACKGROUND AND INTRODUCTION: The place of last care carries importance for patients at the end of life. It is influenced by the realities of the social welfare and healthcare systems, cultural aspects, and symptom burden. This study aims to investigate the place of care trajectories of patients admitted to an acute palliative care unit. MATERIALS AND METHODS: The medical records of all patients hospitalized on our acute palliative care unit in 2019 were assessed. Demographic, socio-economic and disease characteristics were recorded. Descriptive and inferential statistics were used to identify determinants for place of last care. RESULTS: A total of 377 patients were included in this study. Median age was 71 (IQR, 59–81) years. Of these patients, 56% (n = 210) were male. The majority of patients was Swiss (80%; n = 300); about 60% (n = 226) reported a Christian confession; and 77% had completed high school or tertiary education. Most patients (80%, n = 300) had a cancer diagnosis. The acute palliative care unit was the place of last care for 54% of patients. Gender, nationality, religion, health insurance, and highest level of completed education were no predictors for place of last care, yet previous outpatient palliative care involvement decreased the odds of dying in a hospital (OR, 0.301; 95% CI, 0.180–0.505; p-value < 0.001). CONCLUSION: More than half of patients admitted for end-of-life care died on the acute palliative care unit. While socio-economic factors did not determine place of last care, previous involvement of outpatient palliative care is a lever to facilitate dying at home. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-023-01240-2. BioMed Central 2023-08-08 /pmc/articles/PMC10408184/ /pubmed/37550688 http://dx.doi.org/10.1186/s12904-023-01240-2 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Christ, Sebastian M.
Hünerwadel, Ellen
Hut, Bigna
Ahmadsei, Maiwand
Matthes, Oliver
Seiler, Annina
Schettle, Markus
Blum, David
Hertler, Caroline
Socio-economic determinants for the place of last care: results from the acute palliative care unit of a large comprehensive cancer center in a high-income country in Europe
title Socio-economic determinants for the place of last care: results from the acute palliative care unit of a large comprehensive cancer center in a high-income country in Europe
title_full Socio-economic determinants for the place of last care: results from the acute palliative care unit of a large comprehensive cancer center in a high-income country in Europe
title_fullStr Socio-economic determinants for the place of last care: results from the acute palliative care unit of a large comprehensive cancer center in a high-income country in Europe
title_full_unstemmed Socio-economic determinants for the place of last care: results from the acute palliative care unit of a large comprehensive cancer center in a high-income country in Europe
title_short Socio-economic determinants for the place of last care: results from the acute palliative care unit of a large comprehensive cancer center in a high-income country in Europe
title_sort socio-economic determinants for the place of last care: results from the acute palliative care unit of a large comprehensive cancer center in a high-income country in europe
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10408184/
https://www.ncbi.nlm.nih.gov/pubmed/37550688
http://dx.doi.org/10.1186/s12904-023-01240-2
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