Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Kjellstadli, Camilla, Allore, Heather, Husebo, Bettina S, Flo, Elisabeth, Sandvik, Hogne, Hunskaar, Steinar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
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
_version_ 1783562196600487936
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
work_keys_str_mv AT kjellstadlicamilla generalpractitionersprovisionofendoflifecareandassociationswithdyingathomearegistrybasedlongitudinalstudy
AT alloreheather generalpractitionersprovisionofendoflifecareandassociationswithdyingathomearegistrybasedlongitudinalstudy
AT husebobettinas generalpractitionersprovisionofendoflifecareandassociationswithdyingathomearegistrybasedlongitudinalstudy
AT floelisabeth generalpractitionersprovisionofendoflifecareandassociationswithdyingathomearegistrybasedlongitudinalstudy
AT sandvikhogne generalpractitionersprovisionofendoflifecareandassociationswithdyingathomearegistrybasedlongitudinalstudy
AT hunskaarsteinar generalpractitionersprovisionofendoflifecareandassociationswithdyingathomearegistrybasedlongitudinalstudy