HOPEVOL: Hospice Patients Admitted to the Different Types of Hospice Facilities in the Netherlands

Background: Hospice care in the Netherlands is provided in three different types of hospice facilities: Volunteer-Driven Hospices (VD), Hospice Unit Nursing Homes (HU), and Stand Alone Hospices (SA). The organizational structure ranges from care provided by trained volunteers in VD to care provided by multi professional teams in SA and HU. Aims: Describe and compare patients and patient’s needs at admission in hospices. Methods: A retrospective study using patient records. Adult hospice inpatients deceased in 2017-2018 were enrolled. A random sample of 17 hospices per hospice type was drawn. Main outcome were patient’s needs in the four dimensions. Physical symptoms and performance status were collected, as were psychological problems concerning cognition and emotion, social concerns involving caregivers / family, and existential needs. Potential differences between the patients in the different types of hospices were tested with either a chi-squared or a Kruskal-Wallis test. Results: At this moment 712 patients are included from 45 hospices (13 VD, 15 HU, 17 SA), median age 77, IQR [69-85], 78% with cancer, and 47% were >50% of the day bedridden. At admission, all patients perceived physical needs. Psychological needs were experienced by 37%, 34%, and 36% patients (p=.77) and social needs by 53%, 62% and 53% (p=.10) in VD, HU and SA resp. Existential needs differed between patients per type of hospice: 23%, 18% and 30% (p=.005) in VD, HU and SA resp. Of all patients, 29% experienced problems in three and 5% in four dimensions (not different between types of hospices). Conclusion The comparability of patients between hospice types shows that a patient’s needs do not seem decisive for the choice of hospice in the Netherlands. Discussion: Between hospices, patient records have different formats, varying from comprehensive chronicles to separated files per type of professional. Future research will focus on effects of type of registration for retrospective studies.