Actual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators.

<h4>Background</h4>Dying at home and dying at the preferred place of death are advocated to be desirable outcomes of palliative care. More insight is needed in their usefulness as quality indicators. Our objective is to describe whether "the percentage of patients dying at home"...

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Autores principales:	Maaike L De Roo, Guido Miccinesi, Bregje D Onwuteaka-Philipsen, Nele Van Den Noortgate, Lieve Van den Block, Andrea Bonacchi, Gé A Donker, Jose E Lozano Alonso, Sarah Moreels, Luc Deliens, Anneke L Francke, EURO IMPACT
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/0a14ffa165314a87af1a8e84b7906278
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spelling	oai:doaj.org-article:0a14ffa165314a87af1a8e84b79062782021-11-18T08:24:28ZActual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators.1932-620310.1371/journal.pone.0093762https://doaj.org/article/0a14ffa165314a87af1a8e84b79062782014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24714736/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Dying at home and dying at the preferred place of death are advocated to be desirable outcomes of palliative care. More insight is needed in their usefulness as quality indicators. Our objective is to describe whether "the percentage of patients dying at home" and "the percentage of patients who died in their place of preference" are feasible and informative quality indicators.<h4>Methods and findings</h4>A mortality follow-back study was conducted, based on data recorded by representative GP networks regarding home-dwelling patients who died non-suddenly in Belgium (n = 1036), The Netherlands (n = 512), Italy (n = 1639) or Spain (n = 565). "The percentage of patients dying at home" ranged between 35.3% (Belgium) and 50.6% (The Netherlands) in the four countries, while "the percentage of patients dying at their preferred place of death" ranged between 67.8% (Italy) and 86.0% (Spain). Both indicators were strongly associated with palliative care provision by the GP (odds ratios of 1.55-13.23 and 2.30-6.63, respectively). The quality indicator concerning the preferred place of death offers a broader view than the indicator concerning home deaths, as it takes into account all preferences met in all locations. However, GPs did not know the preferences for place of death in 39.6% (The Netherlands) to 70.3% (Italy), whereas the actual place of death was known in almost all cases.<h4>Conclusion</h4>GPs know their patients' actual place of death, making the percentage of home deaths a feasible indicator for collection by GPs. However, patients' preferred place of death was often unknown to the GP. We therefore recommend using information from relatives as long as information from GPs on the preferred place of death is lacking. Timely communication about the place where patients want to be cared for at the end of life remains a challenge for GPs.Maaike L De RooGuido MiccinesiBregje D Onwuteaka-PhilipsenNele Van Den NoortgateLieve Van den BlockAndrea BonacchiGé A DonkerJose E Lozano AlonsoSarah MoreelsLuc DeliensAnneke L FranckeEURO IMPACTPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e93762 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Maaike L De Roo Guido Miccinesi Bregje D Onwuteaka-Philipsen Nele Van Den Noortgate Lieve Van den Block Andrea Bonacchi Gé A Donker Jose E Lozano Alonso Sarah Moreels Luc Deliens Anneke L Francke EURO IMPACT Actual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators.
description	<h4>Background</h4>Dying at home and dying at the preferred place of death are advocated to be desirable outcomes of palliative care. More insight is needed in their usefulness as quality indicators. Our objective is to describe whether "the percentage of patients dying at home" and "the percentage of patients who died in their place of preference" are feasible and informative quality indicators.<h4>Methods and findings</h4>A mortality follow-back study was conducted, based on data recorded by representative GP networks regarding home-dwelling patients who died non-suddenly in Belgium (n = 1036), The Netherlands (n = 512), Italy (n = 1639) or Spain (n = 565). "The percentage of patients dying at home" ranged between 35.3% (Belgium) and 50.6% (The Netherlands) in the four countries, while "the percentage of patients dying at their preferred place of death" ranged between 67.8% (Italy) and 86.0% (Spain). Both indicators were strongly associated with palliative care provision by the GP (odds ratios of 1.55-13.23 and 2.30-6.63, respectively). The quality indicator concerning the preferred place of death offers a broader view than the indicator concerning home deaths, as it takes into account all preferences met in all locations. However, GPs did not know the preferences for place of death in 39.6% (The Netherlands) to 70.3% (Italy), whereas the actual place of death was known in almost all cases.<h4>Conclusion</h4>GPs know their patients' actual place of death, making the percentage of home deaths a feasible indicator for collection by GPs. However, patients' preferred place of death was often unknown to the GP. We therefore recommend using information from relatives as long as information from GPs on the preferred place of death is lacking. Timely communication about the place where patients want to be cared for at the end of life remains a challenge for GPs.
format	article
author	Maaike L De Roo Guido Miccinesi Bregje D Onwuteaka-Philipsen Nele Van Den Noortgate Lieve Van den Block Andrea Bonacchi Gé A Donker Jose E Lozano Alonso Sarah Moreels Luc Deliens Anneke L Francke EURO IMPACT
author_facet	Maaike L De Roo Guido Miccinesi Bregje D Onwuteaka-Philipsen Nele Van Den Noortgate Lieve Van den Block Andrea Bonacchi Gé A Donker Jose E Lozano Alonso Sarah Moreels Luc Deliens Anneke L Francke EURO IMPACT
author_sort	Maaike L De Roo
title	Actual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators.
title_short	Actual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators.
title_full	Actual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators.
title_fullStr	Actual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators.
title_full_unstemmed	Actual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators.
title_sort	actual and preferred place of death of home-dwelling patients in four european countries: making sense of quality indicators.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/0a14ffa165314a87af1a8e84b7906278
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Actual and preferred place of death of home-dwelling patients in four European countries: making sense of quality indicators.

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