Effectiveness of two types of palliative home care in cancer and non-cancer patients: A retrospective population-based study using claims data.
Germany
administrative claims
homecare services
palliative care
primary health care
quality of health care
retrospective studies
terminal care
Journal
Palliative medicine
ISSN: 1477-030X
Titre abrégé: Palliat Med
Pays: England
ID NLM: 8704926
Informations de publication
Date de publication:
06 2021
06 2021
Historique:
entrez:
7
6
2021
pubmed:
8
6
2021
medline:
25
6
2021
Statut:
ppublish
Résumé
Comparative effectiveness of different types of palliative homecare is sparsely researched internationally-despite its potential to inform necessary decisions in palliative care infrastructure development. In Germany, specialized palliative homecare delivered by multi-professional teams has increased in recent years and factors beyond medical need seem to drive its involvement and affect the application of primary palliative care, delivered by general practitioners who are supported by nursing services. To compare effectiveness of primary palliative care and specialized palliative homecare in reducing potentially aggressive interventions at the end-of-life in cancer and non-cancer. Retrospective population-based study with claims data from 95,962 deceased adults in Germany in 2016 using multivariable regression analyses. Patients having received primary palliative care or specialized palliative homecare (alone or in addition to primary palliative care), for at least 14 days before death, differentiating between cancer and non-cancer patients. Rates of potentially aggressive interventions in most indicators were higher in primary palliative care than in specialized palliative homecare ( Specialized palliative homecare is more strongly associated with reduction of potentially aggressive interventions than primary palliative care in the last days of life. Future research should identify elements of specialized palliative homecare applicable for more effective primary palliative care, too. German Clinical Trials Register (DRKS00014730).
Sections du résumé
BACKGROUND
Comparative effectiveness of different types of palliative homecare is sparsely researched internationally-despite its potential to inform necessary decisions in palliative care infrastructure development. In Germany, specialized palliative homecare delivered by multi-professional teams has increased in recent years and factors beyond medical need seem to drive its involvement and affect the application of primary palliative care, delivered by general practitioners who are supported by nursing services.
AIM
To compare effectiveness of primary palliative care and specialized palliative homecare in reducing potentially aggressive interventions at the end-of-life in cancer and non-cancer.
DESIGN
Retrospective population-based study with claims data from 95,962 deceased adults in Germany in 2016 using multivariable regression analyses.
SETTINGS/PARTICIPANTS
Patients having received primary palliative care or specialized palliative homecare (alone or in addition to primary palliative care), for at least 14 days before death, differentiating between cancer and non-cancer patients.
RESULTS
Rates of potentially aggressive interventions in most indicators were higher in primary palliative care than in specialized palliative homecare (
CONCLUSION
Specialized palliative homecare is more strongly associated with reduction of potentially aggressive interventions than primary palliative care in the last days of life. Future research should identify elements of specialized palliative homecare applicable for more effective primary palliative care, too. German Clinical Trials Register (DRKS00014730).
Identifiants
pubmed: 34092140
doi: 10.1177/02692163211013666
pmc: PMC8189010
doi:
Banques de données
DRKS
['DRKS00014730']
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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