Hospice care in the Netherlands: who applies and who is admitted to inpatient careReport as inadecuate




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BMC Health Services Research

, 16:33

Healthcare needs and demand

Abstract

BackgroundTen percent of non-sudden deaths in the Netherlands occur in inpatient hospice facilities. To investigate differences between patients who are admitted to inpatient hospice care or not following application, how diagnoses compare to the national population, characteristics of application, and associations with being admitted to inpatient hospice care or not.

MethodsData from a database representing over 25 % of inpatient hospice facilities in the Netherlands were analysed. The study period spanned the years 2007–2012. Multivariate regression analyses were performed to study associations between demographic and application characteristics, and admittance.

ResultsTen thousand two hundred fifty-four patients were included. 84.1 % of patients applying for inpatient hospice care had cancer compared to 37.0 % of deaths nationally. 52.4 % of applicants resided in hospital at the time of admission. Most frequent reasons for application were the wish to die in an inpatient hospice facility 70.5 %, needing intensive care or support 52.2 %, relieving caregivers 41.4 % and needing pain-symptom control 39.9 %. Living alone OR 1.68, 95 % CI 1.46–1.94, having cancer OR 1.40, 95 % CI 1.11–1.76, relieving caregivers OR 1.18, 95 % CI 1.01–1.38, needing pain-symptom control OR1.72, 95 % CI 1.46–2.03 wanting inpatient hospice care until death vs respite care OR 3.59, 95 % CI 2.11–6.10, wanting to be admitted as soon as possible OR 1.64, 95 % CI 1.42–1.88, and being referred by a primary care professional OR 1.36, 95 % CI 1.17–1.59 were positively associated with being admitted. Wishing to die in an inpatient hospice facility was negatively associated with being admitted OR 0.85, 95 % CI 0.72–1.00.

ConclusionsThis study suggests that when applying for inpatient hospice care, patients who seem most urgently in need of inpatient hospice care are more frequently admitted. However, non-cancer patients seem to be an under-represented population. Staff should consider application based on need for palliation, irrespective of diagnosis.

KeywordsInpatient hospice care Cancer End of life Palliative care Nurses Nursing  Download fulltext PDF



Author: Emily West - H. Roeline Pasman - Cilia Galesloot - Martine Elizabeth Lokker - Bregje Onwuteaka-Philipsen - On behalf of EUR

Source: https://link.springer.com/







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