Cargando…
Continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance
BACKGROUND: The goal of palliative care is to prevent and alleviate a suffering of incurable ill patients. A continuous intersectoral palliative care is important. The aim of this study is to analyse the continuity of palliative care, particularly the time gaps between hospital discharge and subsequ...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045326/ https://www.ncbi.nlm.nih.gov/pubmed/33849501 http://dx.doi.org/10.1186/s12904-021-00751-0 |
_version_ | 1783678661543591936 |
---|---|
author | Rehner, Laura Moon, Kilson Hoffmann, Wolfgang van den Berg, Neeltje |
author_facet | Rehner, Laura Moon, Kilson Hoffmann, Wolfgang van den Berg, Neeltje |
author_sort | Rehner, Laura |
collection | PubMed |
description | BACKGROUND: The goal of palliative care is to prevent and alleviate a suffering of incurable ill patients. A continuous intersectoral palliative care is important. The aim of this study is to analyse the continuity of palliative care, particularly the time gaps between hospital discharge and subsequent palliative care as well as the timing of the last palliative care before the patient’s death. METHODS: The analysis was based on claims data from a large statutory health insurance. Patients who received their first palliative care in 2015 were included. The course of palliative care was followed for 12 months. Time intervals between discharge from hospital and first subsequent palliative care as well as between last palliative care and death were analysed. The continuity in palliative care was defined as an interval of less than 14 days between palliative care. Data were analysed using descriptive statistics and Chi-Square. RESULTS: In 2015, 4177 patients with first palliative care were identified in the catchment area of the statutory health insurance. After general inpatient palliative care, 415 patients were transferred to subsequent palliative care, of these 67.7% (n = 281) received subsequent care within 14 days. After a stay in a palliative care ward, 124 patients received subsequent palliative care, of these 75.0% (n = 93) within 14 days. Altogether, 147 discharges did not receive subsequent palliative care. During the 12-months follow-up period, 2866 (68.7%) patients died, of these 78.7% (n = 2256) received palliative care within the last 2 weeks of life. Of these, 1223 patients received general ambulatory palliative care, 631 patients received specialised ambulatory palliative care, 313 patients received their last palliative care at a hospital and 89 patients received it in a hospice. CONCLUSIONS: The majority of the palliative care patients received continuous palliative care. However, there are some patients who did not receive continuous palliative care. After inpatient palliative care, each patient should receive a discharge management for a continuation of palliative care. Readmissions of patients after discharge from inpatients palliative care can be an indication for a lack of support in the ambulatory health care setting and for an insufficient discharge management. Palliative care training and possibilities for palliative care consultations by specialists should strengthen the GPs in palliative care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-021-00751-0. |
format | Online Article Text |
id | pubmed-8045326 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-80453262021-04-14 Continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance Rehner, Laura Moon, Kilson Hoffmann, Wolfgang van den Berg, Neeltje BMC Palliat Care Research BACKGROUND: The goal of palliative care is to prevent and alleviate a suffering of incurable ill patients. A continuous intersectoral palliative care is important. The aim of this study is to analyse the continuity of palliative care, particularly the time gaps between hospital discharge and subsequent palliative care as well as the timing of the last palliative care before the patient’s death. METHODS: The analysis was based on claims data from a large statutory health insurance. Patients who received their first palliative care in 2015 were included. The course of palliative care was followed for 12 months. Time intervals between discharge from hospital and first subsequent palliative care as well as between last palliative care and death were analysed. The continuity in palliative care was defined as an interval of less than 14 days between palliative care. Data were analysed using descriptive statistics and Chi-Square. RESULTS: In 2015, 4177 patients with first palliative care were identified in the catchment area of the statutory health insurance. After general inpatient palliative care, 415 patients were transferred to subsequent palliative care, of these 67.7% (n = 281) received subsequent care within 14 days. After a stay in a palliative care ward, 124 patients received subsequent palliative care, of these 75.0% (n = 93) within 14 days. Altogether, 147 discharges did not receive subsequent palliative care. During the 12-months follow-up period, 2866 (68.7%) patients died, of these 78.7% (n = 2256) received palliative care within the last 2 weeks of life. Of these, 1223 patients received general ambulatory palliative care, 631 patients received specialised ambulatory palliative care, 313 patients received their last palliative care at a hospital and 89 patients received it in a hospice. CONCLUSIONS: The majority of the palliative care patients received continuous palliative care. However, there are some patients who did not receive continuous palliative care. After inpatient palliative care, each patient should receive a discharge management for a continuation of palliative care. Readmissions of patients after discharge from inpatients palliative care can be an indication for a lack of support in the ambulatory health care setting and for an insufficient discharge management. Palliative care training and possibilities for palliative care consultations by specialists should strengthen the GPs in palliative care. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-021-00751-0. BioMed Central 2021-04-13 /pmc/articles/PMC8045326/ /pubmed/33849501 http://dx.doi.org/10.1186/s12904-021-00751-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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 Rehner, Laura Moon, Kilson Hoffmann, Wolfgang van den Berg, Neeltje Continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance |
title | Continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance |
title_full | Continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance |
title_fullStr | Continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance |
title_full_unstemmed | Continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance |
title_short | Continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance |
title_sort | continuity in palliative care – analysis of intersectoral palliative care based on routine data of a statutory health insurance |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045326/ https://www.ncbi.nlm.nih.gov/pubmed/33849501 http://dx.doi.org/10.1186/s12904-021-00751-0 |
work_keys_str_mv | AT rehnerlaura continuityinpalliativecareanalysisofintersectoralpalliativecarebasedonroutinedataofastatutoryhealthinsurance AT moonkilson continuityinpalliativecareanalysisofintersectoralpalliativecarebasedonroutinedataofastatutoryhealthinsurance AT hoffmannwolfgang continuityinpalliativecareanalysisofintersectoralpalliativecarebasedonroutinedataofastatutoryhealthinsurance AT vandenbergneeltje continuityinpalliativecareanalysisofintersectoralpalliativecarebasedonroutinedataofastatutoryhealthinsurance |