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    Place of care: from referral to specialist palliative care until death.

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    Authors
    O'Leary, Mary Jane
    O'Brien, Alison C
    Murphy, Marie
    Crowley, Claire M
    Leahy, Helen M
    McCarthy, Jill M
    Collins, Joan C
    O'Brien, Tony
    Issue Date
    2014-12-08
    Keywords
    PALLIATIVE CARE
    COMMUNICATION
    HOSPICE
    HOME CARE
    
    Metadata
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    Citation
    Place of care: from referral to specialist palliative care until death. 2014: BMJ Support Palliat Care
    Publisher
    BMJ Publishing Group Ltd
    Journal
    BMJ supportive & palliative care
    URI
    http://hdl.handle.net/10147/348560
    DOI
    10.1136/bmjspcare-2014-000696
    PubMed ID
    25492417
    Additional Links
    http://spcare.bmj.com/content/early/2012/11/20/bmjspcare-2012-000281
    Abstract
    While there are many poorly standardised studies focusing on place of death, there are limited data on place(s) of care during the final stages of disease.
    This study aims to identify where patients are cared for in the interval from referral to specialist palliative care until death.
    All patients who died while under the care of a specialist palliative care service over a 6-month period were considered.
    Of the 507 patients included, 255 (50.3%) were men and 428 (84.4%) had a malignant diagnosis. The mean referral-to-death interval was 70 days (SD 113, Range 1-838). The majority (n=281, 55.4%) received care in a single care setting-hospital (28.4%), home (21.5%), nursing home/community hospital (4.1%), hospice (1.4%)-and had a shorter mean referral-to-death interval. Most patients with more than one care setting spent three-quarters of their time in their normal place of residence. A total of 199 (39.3%) died in hospital, 131 (25.8%) in hospice, 131 (25.8%) at home (25.8%) and 46 (9.1%) in a nursing home/community hospital. Patients referred by a general practitioner (n=80 patients, 15.8%) were more likely to be cared for at home (p<0.001), and die at home (p<0.001).
    A significant number of patients received specialist palliative care across multiple care settings. Late referral is associated with a single domain of care. General practitioner involvement supports patient care and death at home. Place of care and ease of transfer between care settings may be better indicators of the quality of care we provide.
    Item Type
    Article
    Language
    en
    ISSN
    2045-4368
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjspcare-2014-000696
    Scopus Count
    Collections
    Marymount University Hospital & Hospice

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