ABSTRACT
Objetivos: Conocer si existe relación entre el lugar de fallecimiento y el proveedor de cuidados: equipo de atención primaria (EAP), equipo de soporte atención paliativa domiciliaria (ESAPD) o ambos. Identificar otras variables que pueden influir en el lugar de fallecimiento. Diseño: Estudio descriptivo observacional retrospectivo. Emplazamiento: Tres centros de salud, Dirección Asistencial Sureste, Comunidad de Madrid. Participantes: Pacientes mayores de 18 años con episodio A.99.01 (paciente con necesidad de cuidados paliativos), según la codificación CIAP2, activo en su historia clínica informatizada (AP-Madrid) desde enero de 2016 hasta diciembre de 2018 (n=499). No cumplieron criterios de inclusión 224 pacientes. Mediciones y resultados principales: Se incluyeron 275 pacientes, la edad media fue de 78 años. El 80,4% (n=221) tenían enfermedad oncológica. El 67,6% (n=186) pertenecían al ámbito urbano. Existían diferencias significativas entre el lugar de fallecimiento y el equipo proveedor de cuidados: fallecieron en domicilio el 23,1% (n=6) en seguimiento por EAP, el 14,5% (n=10) en seguimiento por ESAPD y el 29,4% (n=53) con seguimiento conjunto (p<0,0001). Fallecieron en domicilio el 20,8% (n=46) de pacientes oncológicos y el 42,6% (n=23) no oncológicos (p<0,0001). El 26,5% (n=63) de los fallecidos en domicilio tenían cuidador principal y el 16,2% (n=6) no lo tenían (p<0,0001). Fallecieron en domicilio el 34,8% (n=31) del ámbito rural y el 20,4% (n=38) del ámbito urbano (p<0,007). Conclusiones: Los resultados avalan que el seguimiento conjunto aumenta el porcentaje de fallecimientos en domicilio.(AU)
Objectives: To determine whether there is a link between the place of death and the type of health-care provider: Primary Healthcare Team (PHT), Home Palliative Care Support Team (HPCST), or both. To identify other variables that may affect the place of death. Design of study: Descriptive, observational, retrospective study. Setting: Three primary care center, Dirección Asistencial Sureste, Comunidad de Madrid (Madrid, Spain). Participants: Patients over the age of 18 with an A.99.01 episode (patient palliative care supports) according to coding CIAP2, active in their electronic medical record (AP-Madrid) from January 2016 until December 2018 (n=499). Two hundred and twenty four (224) patients did not meet the inclusion criteria. Main measurements and results: Two hundred and seventy five (275) patients were included. Their average age was 78. Eighty point four (80.4%) (n=221) patients had oncologic disease. Sixty seven point six (67.6%) (n=186) lived in an urban setting. There were significant differences (P<0.0001) between the place of death and the type of health-care provider team. Death occurred at home for: 23.1% (n=6) patients in follow-up by PHTs, 14.5% (n=10) patients in follow-up by HPCSTs, and 29.4% (n=53) patients in joint follow-up; 20.8% (n=46) were oncologic patients and 42.6% (n=23) were non-oncologic patients; 26.5% (n=63) had a main caregiver and 16.2% (n=6) didnt. Death occurred at home for 34.8% (n=31) of rural setting patients and for 20.4% (n=38) of urban setting patients (P<0.007). Conclusions: Results support a higher percentage of deaths at home with joint follow-up.(AU)
Subject(s)
Humans , Male , Female , Primary Health Care , Death , Palliative Care , Rural Areas , Home Care Services, Hospital-Based , Home Nursing , Health Centers , Spain , Epidemiology, Descriptive , Retrospective StudiesABSTRACT
OBJECTIVES: To determine whether there is a link between the place of death and the type of health-care provider: Primary Healthcare Team (PHT), Home Palliative Care Support Team (HPCST), or both. To identify other variables that may affect the place of death. DESIGN OF STUDY: Descriptive, observational, retrospective study. SETTING: Three primary care center, Dirección Asistencial Sureste, Comunidad de Madrid (Madrid, Spain). PARTICIPANTS: Patients over the age of 18 with an A.99.01 episode (patient palliative care supports) according to coding CIAP2, active in their electronic medical record (AP-Madrid) from January 2016 until December 2018 (n=499). Two hundred and twenty four (224) patients did not meet the inclusion criteria. MAIN MEASUREMENTS AND RESULTS: Two hundred and seventy five (275) patients were included. Their average age was 78. Eighty point four (80.4%) (n=221) patients had oncologic disease. Sixty seven point six (67.6%) (n=186) lived in an urban setting. There were significant differences (P<0.0001) between the place of death and the type of health-care provider team. Death occurred at home for: 23.1% (n=6) patients in follow-up by PHTs, 14.5% (n=10) patients in follow-up by HPCSTs, and 29.4% (n=53) patients in joint follow-up; 20.8% (n=46) were oncologic patients and 42.6% (n=23) were non-oncologic patients; 26.5% (n=63) had a main caregiver and 16.2% (n=6) didn't. Death occurred at home for 34.8% (n=31) of rural setting patients and for 20.4% (n=38) of urban setting patients (P<0.007). CONCLUSIONS: Results support a higher percentage of deaths at home with joint follow-up.
