Samenvatting
Objectives. To describe and compare the use of palliative care delivered by general practitioners (GPs), the use and time of onset of specialist palliative care initiatives (SPCI), and associated patient-, illness-, and care-related characteristics in four European countries.
Design. Cross-national mortality follow-back survey.
Setting. Belgium, Netherlands, Italy, Spain (autonomous regions Comunidad Valenicana and Castilla y Leon).
Participants: Members of GP Sentinel networks of the four countries registered every death of a patient (18 years or older) in their practice during 2009 and 2010 (in Spain only 2010) using a standardized registration form and provided illness, and care-related information concerning that person's last three months of life. Deaths rated as sudden by the GP and nursing home deaths from the Netherlands were excluded.
Main outcome measures. Proportion of patients who received palliative care by the GP; proportion attended by SPCI; number of days between first intervention of a SPCI and death.
Results. We studied 4.466 deaths. Between 62% (Belgium) and 72% (Spain) of patients received palliative care. Palliative care by GPs was more widespread than use of SPCI, ranging from 50% (Belgium) to 65% (Spain), as compared to 29% (Netherlands) to 47% (Belgium) attended by SPCI. Italy revealed the earliest time of onset of SPCI before death (median 30 days) and Belgium the latest (median 15 days). Cancer diagnosis and home death were the most consistent predictors for receiving palliative care. Younger age was associated with higher chances of receiving care from SPCI in Italy and Spain. No relationship between age and palliative care by GPs was found.
Conclusions. The obtained differences in use of palliative care and time of onset can partly be explained by countries' health care policies and organisation of palliative care. An important role of the GP in palliative care for the elderly is suggested.
Design. Cross-national mortality follow-back survey.
Setting. Belgium, Netherlands, Italy, Spain (autonomous regions Comunidad Valenicana and Castilla y Leon).
Participants: Members of GP Sentinel networks of the four countries registered every death of a patient (18 years or older) in their practice during 2009 and 2010 (in Spain only 2010) using a standardized registration form and provided illness, and care-related information concerning that person's last three months of life. Deaths rated as sudden by the GP and nursing home deaths from the Netherlands were excluded.
Main outcome measures. Proportion of patients who received palliative care by the GP; proportion attended by SPCI; number of days between first intervention of a SPCI and death.
Results. We studied 4.466 deaths. Between 62% (Belgium) and 72% (Spain) of patients received palliative care. Palliative care by GPs was more widespread than use of SPCI, ranging from 50% (Belgium) to 65% (Spain), as compared to 29% (Netherlands) to 47% (Belgium) attended by SPCI. Italy revealed the earliest time of onset of SPCI before death (median 30 days) and Belgium the latest (median 15 days). Cancer diagnosis and home death were the most consistent predictors for receiving palliative care. Younger age was associated with higher chances of receiving care from SPCI in Italy and Spain. No relationship between age and palliative care by GPs was found.
Conclusions. The obtained differences in use of palliative care and time of onset can partly be explained by countries' health care policies and organisation of palliative care. An important role of the GP in palliative care for the elderly is suggested.
| Originele taal-2 | English |
|---|---|
| Titel | Nederlands-Vlaams Tijdschrift voor Palliatieve Zorg |
| Status | Published - 2012 |
| Evenement | Unknown - Duur: 1 jan 2012 → … |
Publicatie series
| Naam | Nederlands-Vlaams Tijdschrift voor Palliatieve Zorg |
|---|---|
| Nummer | 1 |
Conference
| Conference | Unknown |
|---|---|
| Periode | 1/01/12 → … |