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Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands
BACKGROUND: Specialist palliative care teams (SPCTs) in hospitals improve quality of life and satisfaction with care for patients with advanced disease. However, referrals to SPCTs are often limited. To identify areas for improvement of SPCTs’ service penetration, we explored the characteristics and...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582112/ https://www.ncbi.nlm.nih.gov/pubmed/34758792 http://dx.doi.org/10.1186/s12904-021-00875-3 |
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author | Boddaert, M.S. Stoppelenburg, A. Hasselaar, J. van der Linden, Y.M. Vissers, K.C.P. Raijmakers, N.J.H. Brom, L. |
author_facet | Boddaert, M.S. Stoppelenburg, A. Hasselaar, J. van der Linden, Y.M. Vissers, K.C.P. Raijmakers, N.J.H. Brom, L. |
author_sort | Boddaert, M.S. |
collection | PubMed |
description | BACKGROUND: Specialist palliative care teams (SPCTs) in hospitals improve quality of life and satisfaction with care for patients with advanced disease. However, referrals to SPCTs are often limited. To identify areas for improvement of SPCTs’ service penetration, we explored the characteristics and level of integration of palliative care programmes and SPCTs in Dutch hospitals and we assessed the relation between these characteristics and specialist palliative care referral rates. METHODS: We performed a secondary analysis of a national cross-sectional survey conducted among hospitals in the Netherlands from March through May 2018. For this survey, a previously developed online questionnaire, containing 6 consensus-based integration indicators, was sent to palliative care programme leaders in all 78 hospitals. For referral rate we calculated the number of annual inpatient referrals to the SPCT as a percentage of the number of total annual hospital admissions. Referral rate was dichotomized into high (≥ third quartile) and low (< third quartile). Characteristics of SPCTs with high and low referral rate were compared using univariate analyses. P-values < 0.05 were considered significant. RESULTS: In total, 63 hospitals (81%) participated in the survey, of which 62 had an operational SPCT. The palliative care programmes of these hospitals consisted of inpatient consultation services (94%), interdisciplinary staffing (61%), outpatient clinics (45%), dedicated acute care beds (21%) and community-based palliative care (27%). The median referral rate was 0.56% (IQR 0.23–1.0%), ranging from 0 to 3.7%. Comparing SPCTs with high referral rate (≥1%, n = 17) and low referral rate (< 1%, n = 45) showed significant differences for SPCTs’ years of existence, staffing, their level of education, participation in other departments’ team meetings, provision of education and conducting research. With regard to integration, significant differences were found for the presence of outpatient clinics and timing of referrals. CONCLUSION: In the Netherlands, palliative care programmes and specialist palliative care teams in hospitals vary in their level of integration and development, with more mature teams showing higher referral rates. Appropriate staffing, dedicated outpatient clinics, education and research appear means to improve service penetration and timing of referral for patients with advanced diseases. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-021-00875-3. |
format | Online Article Text |
id | pubmed-8582112 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-85821122021-11-15 Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands Boddaert, M.S. Stoppelenburg, A. Hasselaar, J. van der Linden, Y.M. Vissers, K.C.P. Raijmakers, N.J.H. Brom, L. BMC Palliat Care Research BACKGROUND: Specialist palliative care teams (SPCTs) in hospitals improve quality of life and satisfaction with care for patients with advanced disease. However, referrals to SPCTs are often limited. To identify areas for improvement of SPCTs’ service penetration, we explored the characteristics and level of integration of palliative care programmes and SPCTs in Dutch hospitals and we assessed the relation between these characteristics and specialist palliative care referral rates. METHODS: We performed a secondary analysis of a national cross-sectional survey conducted among hospitals in the Netherlands from March through May 2018. For this survey, a previously developed online questionnaire, containing 6 consensus-based integration indicators, was sent to palliative care programme leaders in all 78 hospitals. For referral rate we calculated the number of annual inpatient referrals to the SPCT as a percentage of the number of total annual hospital admissions. Referral rate was dichotomized into high (≥ third quartile) and low (< third quartile). Characteristics of SPCTs with high and low referral rate were compared using univariate analyses. P-values < 0.05 were considered significant. RESULTS: In total, 63 hospitals (81%) participated in the survey, of which 62 had an operational SPCT. The palliative care programmes of these hospitals consisted of inpatient consultation services (94%), interdisciplinary staffing (61%), outpatient clinics (45%), dedicated acute care beds (21%) and community-based palliative care (27%). The median referral rate was 0.56% (IQR 0.23–1.0%), ranging from 0 to 3.7%. Comparing SPCTs with high referral rate (≥1%, n = 17) and low referral rate (< 1%, n = 45) showed significant differences for SPCTs’ years of existence, staffing, their level of education, participation in other departments’ team meetings, provision of education and conducting research. With regard to integration, significant differences were found for the presence of outpatient clinics and timing of referrals. CONCLUSION: In the Netherlands, palliative care programmes and specialist palliative care teams in hospitals vary in their level of integration and development, with more mature teams showing higher referral rates. Appropriate staffing, dedicated outpatient clinics, education and research appear means to improve service penetration and timing of referral for patients with advanced diseases. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12904-021-00875-3. BioMed Central 2021-11-11 /pmc/articles/PMC8582112/ /pubmed/34758792 http://dx.doi.org/10.1186/s12904-021-00875-3 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 Boddaert, M.S. Stoppelenburg, A. Hasselaar, J. van der Linden, Y.M. Vissers, K.C.P. Raijmakers, N.J.H. Brom, L. Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands |
title | Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands |
title_full | Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands |
title_fullStr | Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands |
title_full_unstemmed | Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands |
title_short | Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands |
title_sort | specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the netherlands |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8582112/ https://www.ncbi.nlm.nih.gov/pubmed/34758792 http://dx.doi.org/10.1186/s12904-021-00875-3 |
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