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Reasons for and frequency of end-of-life hospital admissions : GPs perspective on reducing end-of-life hospital referrals

Giezendanner, Stéphanie and Bally, Klaus and Haller, Dagmar M. and Jung, Corinna and Otte, Ina C. and Banderet, Hans-Ruedi and Elger, Bernice S. and Zemp, Elisabeth and Gudat, Heike. (2018) Reasons for and frequency of end-of-life hospital admissions : GPs perspective on reducing end-of-life hospital referrals. Journal of Palliative Medicine, 21 (8). pp. 1122-1130.

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Official URL: https://edoc.unibas.ch/65666/

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Abstract

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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Society, Gender and Health > Gender and Health (Zemp Stutz)
UniBasel Contributors:Zemp Stutz, Elisabeth and Elger, Bernice Simone
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Mary Ann Liebert
ISSN:1096-6218
e-ISSN:1557-7740
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:15 Feb 2019 13:28
Deposited On:15 Nov 2018 10:04

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