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General practitioners' provision of end-of-life care and associations with dying at home: a registry-based longitudinal study
BACKGROUND: General practitioners (GPs) may play an important role in providing end-of-life care to community-dwelling people. OBJECTIVE: To investigate patients' contacts with GPs, GPs' interdisciplinary collaboration, out-of-hours services and hospitalizations in the last 13 weeks of lif...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377342/ https://www.ncbi.nlm.nih.gov/pubmed/31995182 http://dx.doi.org/10.1093/fampra/cmz059 |
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author | Kjellstadli, Camilla Allore, Heather Husebo, Bettina S Flo, Elisabeth Sandvik, Hogne Hunskaar, Steinar |
author_facet | Kjellstadli, Camilla Allore, Heather Husebo, Bettina S Flo, Elisabeth Sandvik, Hogne Hunskaar, Steinar |
author_sort | Kjellstadli, Camilla |
collection | PubMed |
description | BACKGROUND: General practitioners (GPs) may play an important role in providing end-of-life care to community-dwelling people. OBJECTIVE: To investigate patients' contacts with GPs, GPs' interdisciplinary collaboration, out-of-hours services and hospitalizations in the last 13 weeks of life and associations with dying at home. Second, investigate whether GP contacts were associated with fewer out-of-hours contacts or days hospitalized. METHODS: Individually linked data from the Norwegian Cause of Death Registry, Norwegian Patient Registry, Statistics Norway and Control and Payment of Reimbursement to Health Service Providers database for all 80 813 deceased people in Norway within 2012–13. Outcomes were analyzed with logistic regression and negative binomial multilevel mixed-effect models. RESULTS: Overall, 1% of people received GP home visits in Week 13 and 4.6% in the last week before death. During the last 4 weeks of life, 9.2% received one or more GP home visits. Altogether, 6.6% received one or more home visits when the GP had one or more interdisciplinary collaborations during the last 4 weeks, of which <3% died at home. GP office consultations decreased towards the end of life. The likelihood of home death versus another location increased in relation to GP home visits [one home visit odds ratio (OR) 1.92, confidence interval (CI) 1.71–2.15; two or more OR 3.49, CI 3.08–3.96] and GP interdisciplinary collaboration (one contact OR 1.76, CI 1.59–1.96; two or more OR 2.52, CI 2.32–2.74). CONCLUSIONS: GPs play a role in enabling people to die at home by performing home visits and collaborating with other health care personnel. Only a minority received such services in Norway. |
format | Online Article Text |
id | pubmed-7377342 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-73773422020-07-27 General practitioners' provision of end-of-life care and associations with dying at home: a registry-based longitudinal study Kjellstadli, Camilla Allore, Heather Husebo, Bettina S Flo, Elisabeth Sandvik, Hogne Hunskaar, Steinar Fam Pract Health Service Research BACKGROUND: General practitioners (GPs) may play an important role in providing end-of-life care to community-dwelling people. OBJECTIVE: To investigate patients' contacts with GPs, GPs' interdisciplinary collaboration, out-of-hours services and hospitalizations in the last 13 weeks of life and associations with dying at home. Second, investigate whether GP contacts were associated with fewer out-of-hours contacts or days hospitalized. METHODS: Individually linked data from the Norwegian Cause of Death Registry, Norwegian Patient Registry, Statistics Norway and Control and Payment of Reimbursement to Health Service Providers database for all 80 813 deceased people in Norway within 2012–13. Outcomes were analyzed with logistic regression and negative binomial multilevel mixed-effect models. RESULTS: Overall, 1% of people received GP home visits in Week 13 and 4.6% in the last week before death. During the last 4 weeks of life, 9.2% received one or more GP home visits. Altogether, 6.6% received one or more home visits when the GP had one or more interdisciplinary collaborations during the last 4 weeks, of which <3% died at home. GP office consultations decreased towards the end of life. The likelihood of home death versus another location increased in relation to GP home visits [one home visit odds ratio (OR) 1.92, confidence interval (CI) 1.71–2.15; two or more OR 3.49, CI 3.08–3.96] and GP interdisciplinary collaboration (one contact OR 1.76, CI 1.59–1.96; two or more OR 2.52, CI 2.32–2.74). CONCLUSIONS: GPs play a role in enabling people to die at home by performing home visits and collaborating with other health care personnel. Only a minority received such services in Norway. Oxford University Press 2020-01-29 /pmc/articles/PMC7377342/ /pubmed/31995182 http://dx.doi.org/10.1093/fampra/cmz059 Text en © The Author(s) 2020. Published by Oxford University Press. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Health Service Research Kjellstadli, Camilla Allore, Heather Husebo, Bettina S Flo, Elisabeth Sandvik, Hogne Hunskaar, Steinar General practitioners' provision of end-of-life care and associations with dying at home: a registry-based longitudinal study |
title | General practitioners' provision of end-of-life care and associations with dying at home: a registry-based longitudinal study |
title_full | General practitioners' provision of end-of-life care and associations with dying at home: a registry-based longitudinal study |
title_fullStr | General practitioners' provision of end-of-life care and associations with dying at home: a registry-based longitudinal study |
title_full_unstemmed | General practitioners' provision of end-of-life care and associations with dying at home: a registry-based longitudinal study |
title_short | General practitioners' provision of end-of-life care and associations with dying at home: a registry-based longitudinal study |
title_sort | general practitioners' provision of end-of-life care and associations with dying at home: a registry-based longitudinal study |
topic | Health Service Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377342/ https://www.ncbi.nlm.nih.gov/pubmed/31995182 http://dx.doi.org/10.1093/fampra/cmz059 |
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