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. ISSN 1477-030XFull text not available from this repository.
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.
|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|
|Deposited On:||30 Jul 2012 10:25|
|Last Modified:||07 Jan 2015 17:40|
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