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Transitions between care settings at the end of life in the Netherlands:results from a nationwide study

Abarshi, Ebun and Echteld, Michael and Van den Block, Lieve and Donker, Gé and Deliens, Luc and Onwuteaka-Philipsen, Bregje (2010) Transitions between care settings at the end of life in the Netherlands:results from a nationwide study. Palliative Medicine, 24 (2). pp. 166-174.

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Abstract

Multiple transitions between care settings in the last phase of life could jeopardize continuity of care and overall end-of-life patient care. Using a mortality follow-back study, we examined the nature and prevalence of transitions between Dutch care settings in the last 3 months of life, and identified potential characteristics associated with them. During the 2-year study period, 690 registered patients died 'totally expectedly and non-suddenly'. These made 709 transitions in the last 3 months, which involved a hospital two times out of three, and covered 43 distinct care trajectories. The most frequent trajectory was home-to-hospital (48%). Forty-six percent experienced one or more transitions in their last month of life. Male gender, multi-morbidities, and absence of GP awareness of a patient's wish for place of death were associated with having a transition in the last 30 days of life; age of <or = 85 years, having an infection and the absence of a palliative-centred treatment goal were associated with terminal hospitalization for > or = 7 days. Although the majority of the 'totally expected and non-sudden' deaths occurred at home, transitions to hospitals were relatively frequent. To minimize abrupt or frequent transitions just before death, timely recognition of the palliative phase of dying is important.

Item Type: Article
Journal or Publication Title: Palliative Medicine
Uncontrolled Keywords: care setting transitions ; comparative study ; end-of-life care ; palliative care ; sentinel GPs ; The Netherlands
Subjects: R Medicine > R Medicine (General)
Departments: Faculty of Health and Medicine > Health Research
ID Code: 56334
Deposited By: ep_importer_pure
Deposited On: 30 Jul 2012 10:25
Refereed?: Yes
Published?: Published
Last Modified: 19 Mar 2013 11:14
Identification Number:
URI: http://eprints.lancs.ac.uk/id/eprint/56334

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