Abstract
This was a quasi-experimental study designed to determine whether, in patients with advanced cancer, a palliative home care team (PHCT) modified hospital utilization in the last six months before death. Of 2503 cancer deaths in the municipality of Genoa, Italy, in 1991, 189 (7.5%) received care from a PHCT. Three hundred and seventy-eight controls matched for primary tumour were selected. The groups were similar in terms of age, gender and most other demographic variables, except that educational level was lower, and times to death, from first diagnosis and from diagnosis of advanced or metastatic cancer, were longer among PHCT patients compared with the controls. Before referral to a PHCT, or a matched time in controls, both groups spent about 15% of days in hospital. After admission to a PHCT, the percentages of days in hospital increased in both groups as death approached, but it was much higher in the control group (30.3%; 95% confidence interval (CI): 26-34) than in the PHCT group (19.0%; 95% CI: 15-23). The difference between groups was most marked in the last month of life, and disappeared among those patients who were in care for more than 120 days (throughout the course of their illness). We conclude that a PHCT appears to reduce days in hospital and allows patients to spend more time at home. Differences in time in care between groups requires further investigations.
| Original language | English |
|---|---|
| Pages (from-to) | 315-321 |
| Number of pages | 7 |
| Journal | Palliative Medicine |
| Volume | 17 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2003 |
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Keywords
- Cancer
- Effectiveness
- Evaluation
- Home care
- Palliative care
ASJC Scopus subject areas
- Medicine(all)
- Nursing(all)
Cite this
Effect of a palliative home care team on hospital admissions among patients with advanced cancer. / Costantini, Massimo; Higginson, Irene J.; Boni, Luca; Orengo, Maria Antonietta; Garrone, Elsa; Henriquet, Franco; Bruzzi, Paolo.
In: Palliative Medicine, Vol. 17, No. 4, 2003, p. 315-321.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of a palliative home care team on hospital admissions among patients with advanced cancer
AU - Costantini, Massimo
AU - Higginson, Irene J.
AU - Boni, Luca
AU - Orengo, Maria Antonietta
AU - Garrone, Elsa
AU - Henriquet, Franco
AU - Bruzzi, Paolo
PY - 2003
Y1 - 2003
N2 - This was a quasi-experimental study designed to determine whether, in patients with advanced cancer, a palliative home care team (PHCT) modified hospital utilization in the last six months before death. Of 2503 cancer deaths in the municipality of Genoa, Italy, in 1991, 189 (7.5%) received care from a PHCT. Three hundred and seventy-eight controls matched for primary tumour were selected. The groups were similar in terms of age, gender and most other demographic variables, except that educational level was lower, and times to death, from first diagnosis and from diagnosis of advanced or metastatic cancer, were longer among PHCT patients compared with the controls. Before referral to a PHCT, or a matched time in controls, both groups spent about 15% of days in hospital. After admission to a PHCT, the percentages of days in hospital increased in both groups as death approached, but it was much higher in the control group (30.3%; 95% confidence interval (CI): 26-34) than in the PHCT group (19.0%; 95% CI: 15-23). The difference between groups was most marked in the last month of life, and disappeared among those patients who were in care for more than 120 days (throughout the course of their illness). We conclude that a PHCT appears to reduce days in hospital and allows patients to spend more time at home. Differences in time in care between groups requires further investigations.
AB - This was a quasi-experimental study designed to determine whether, in patients with advanced cancer, a palliative home care team (PHCT) modified hospital utilization in the last six months before death. Of 2503 cancer deaths in the municipality of Genoa, Italy, in 1991, 189 (7.5%) received care from a PHCT. Three hundred and seventy-eight controls matched for primary tumour were selected. The groups were similar in terms of age, gender and most other demographic variables, except that educational level was lower, and times to death, from first diagnosis and from diagnosis of advanced or metastatic cancer, were longer among PHCT patients compared with the controls. Before referral to a PHCT, or a matched time in controls, both groups spent about 15% of days in hospital. After admission to a PHCT, the percentages of days in hospital increased in both groups as death approached, but it was much higher in the control group (30.3%; 95% confidence interval (CI): 26-34) than in the PHCT group (19.0%; 95% CI: 15-23). The difference between groups was most marked in the last month of life, and disappeared among those patients who were in care for more than 120 days (throughout the course of their illness). We conclude that a PHCT appears to reduce days in hospital and allows patients to spend more time at home. Differences in time in care between groups requires further investigations.
KW - Cancer
KW - Effectiveness
KW - Evaluation
KW - Home care
KW - Palliative care
UR - http://www.scopus.com/inward/record.url?scp=0038001583&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0038001583&partnerID=8YFLogxK
U2 - 10.1191/0269216303pm744oa
DO - 10.1191/0269216303pm744oa
M3 - Article
VL - 17
SP - 315
EP - 321
JO - Palliative Medicine
JF - Palliative Medicine
SN - 0269-2163
IS - 4
ER -