Abstract
Background/aims: In the Netherlands, hospice care is provided in volunteer-driven hospices (VDH) and professional-driven hospices: Hospice-Unit Nursing Homes (HU) and Stand-Alone Hospices (SA). The differences in organizational structures, may lead to differences in care.
Aim: Gain insight into the care provided in hospices with different organizational structures.
Methods: A retrospective file study of deceased patients, admitted in 2016-2018 from 32 randomly selected hospices. Focus on care in the first and the last 72 hours of admission, assessed with the steps of palliative reasoning: 1 signaling new symptom, 2 monitoring symptoms 3 pharmacological interventions, 4 non-pharmacological interventions, 5 evaluating.
Results: Preliminary results of 502 patients (mean age 75,5, 51% female, 79% cancer diagnosis) show that symptoms are mostly signaled in the first 72 hours. Overall pharmacological interventions deployed in the SA is higher than in VDH and HU. However, comparing the first to the last 72 hours, deployed pharmacological interventions increases extensively in VDH and PU. In contrast, the number of non-pharmacological interventions is decreasing.
Conclusions: Symptoms signalled declines during hospice admission and, as expected, symptoms are increasingly monitored over time. Pharmaceutical interventions increase during admission, which might be due to an instable situation at the end of life. There are significant differences in the care process between hospices, except for evaluating in the last 72 hours. Evaluation of the deployed interventions is lacking in all hospices. Though, this is expected to be higher, when more interventions are deployed.
Aim: Gain insight into the care provided in hospices with different organizational structures.
Methods: A retrospective file study of deceased patients, admitted in 2016-2018 from 32 randomly selected hospices. Focus on care in the first and the last 72 hours of admission, assessed with the steps of palliative reasoning: 1 signaling new symptom, 2 monitoring symptoms 3 pharmacological interventions, 4 non-pharmacological interventions, 5 evaluating.
Results: Preliminary results of 502 patients (mean age 75,5, 51% female, 79% cancer diagnosis) show that symptoms are mostly signaled in the first 72 hours. Overall pharmacological interventions deployed in the SA is higher than in VDH and HU. However, comparing the first to the last 72 hours, deployed pharmacological interventions increases extensively in VDH and PU. In contrast, the number of non-pharmacological interventions is decreasing.
Conclusions: Symptoms signalled declines during hospice admission and, as expected, symptoms are increasingly monitored over time. Pharmaceutical interventions increase during admission, which might be due to an instable situation at the end of life. There are significant differences in the care process between hospices, except for evaluating in the last 72 hours. Evaluation of the deployed interventions is lacking in all hospices. Though, this is expected to be higher, when more interventions are deployed.
| Original language | English |
|---|---|
| Article number | P02-356 |
| Journal | Palliative Medicine |
| Volume | 34 |
| Issue number | Suppl_1 |
| Publication status | Published - 21 Sept 2020 |
| Event | EAPC World Research Congress 2020 - online Duration: 7 Oct 2020 → 9 Oct 2020 |