Reasons for and Frequency of End-of-Life Hospital Admissions: General Practitioners' Perspective on Reducing End-of-Life Hospital Referrals.

Détails

ID Serval
serval:BIB_7C633CE4F5D4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Reasons for and Frequency of End-of-Life Hospital Admissions: General Practitioners' Perspective on Reducing End-of-Life Hospital Referrals.
Périodique
Journal of palliative medicine
Auteur(s)
Giezendanner S., Bally K., Haller D.M., Jung C., Otte I.C., Banderet H.R., Elger B.S., Zemp E., Gudat H.
ISSN
1557-7740 (Electronic)
ISSN-L
1557-7740
Statut éditorial
Publié
Date de publication
08/2018
Peer-reviewed
Oui
Volume
21
Numéro
8
Pages
1122-1130
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Many palliative care patients are admitted to hospital shortly before death even though the acute hospital setting is not considered ideal for end-of-life care (EOLC).
This study aimed to evaluate General Practitioners' (GPs') perspective on the frequency of and reasons for hospital referrals of these patients.
Cross-sectional survey involving a stratified random sample of 2000 GPs in Switzerland in 2014. GP characteristics, frequency and type of end-of-life transfers, reasons for referrals, confidence in EOLC, and regional palliative care provision were assessed. Multivariate regression analysis was performed to identify the variables associated with frequency of hospital referrals at the end of life.
The questionnaire was completed by 579 (31%) GPs. Frequent hospital referrals shortly before death were reported by 38%. GPs were less likely to report frequent hospitalizations when they felt confident in palliative care competencies, especially in anticipation of crisis. GPs were more likely to report frequent hospitalizations as being due to relatives' wishes, difficulties in symptom control, inadequate or absent care network, and the expense of palliative care at home.
The results suggest that adequate support of and a care network for palliative patients and their caregivers are crucial for continuous home-based EOLC. Timely recognition of the advanced palliative phase as well as the involvement of well-trained GPs who feel confident in palliative care, together with adequate financial support for outpatient palliative care, might diminish the frequency of transitions shortly before death.
Mots-clé
advance care planning, general practitioners, hospital referrals, palliative care, primary care, survey
Pubmed
Web of science
Création de la notice
08/05/2018 15:17
Dernière modification de la notice
20/08/2019 15:37
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