Hospital admissions at the end of life. Reasons, appropriateness and avoidability

  • Thijs Reyniers ((PhD) Student)
  • Luc Deliens (Promotor)
  • Dirk Houttekier (Promotor)
  • Joachim Cohen (Co-promotor)
  • Robert Vander Stichele (Co-promotor)
  • Dirk Devroey (Jury)
  • Wim Distelmans (Jury)
  • An De Sutter (Jury)
  • Nele Van Den Noortgate (Jury)
  • Johan Wens (Jury)
  • Anneke Francke (Jury)

Scriptie/masterproef: Doctoral Thesis

Uittreksel

The acute hospital setting consistently remains a frequent place of
death in most high-income countries; in Belgium nearly half of all
deaths occur in the hospital setting. To reduce the number of hospital
deaths there has been an increased interest in reducing the number
of end-of-life hospital admissions. The present dissertation aims to
shed some light on the complexity of the reasons for and
circumstances leading to such admissions and to provide a more
thorough understanding about the appropriateness and avoidability of
these admissions.
In a first part, the proportion of older persons with a dementiarelated
disease who die in hospital in Belgium is examined, using
death certificate data. In a second part family physicians’
perspectives are explored concerning their role in preventing and
guiding end-of-life hospital admissions and the difficulties they
experience, using a focus group methodology. In a third part, the
reasons, appropriateness and avoidability of end-of-life hospital
admissions are explored, using a mixed method approach: focus
groups among family physicians and nurses from different care
settings (home care, care home and hospital); interviews with family
carers whose relative had died in hospital; and surveys among family
physicians whose patients had died non-suddenly in the acute
hospital setting of a university hospital.
Although the acute hospital setting is considered not to be an ideal
setting for end-of-life care or as a place of death, most terminal
hospital admissions might be considered appropriate or unavoidable,
either due to a medical complication (e.g. pneumonia), the patients’
preferences or because of an inadequate care setting. Further
implications for policy and practice that could reduce the number of
end-of-life hospital admissions are provided in this dissertation.
Datum Prijs3 jun 2015
TaalEnglish
Toekennende instantie
  • Vrije Universiteit Brussel
  • Ghent University
BegeleiderLuc Deliens (Promotor), Dirk Houttekier (Promotor), Joachim Cohen (Co-promotor), Robert Vander Stichele (Co-promotor), Dirk Devroey (Jury), Wim Distelmans (Jury), Ann De Sutter (Jury), Nele Van Den Noortgate (Jury), Johan Wens (Jury) & A.l. Francke (Jury)

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