Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands

Abstract Background Specialist palliative care teams (SPCTs) in hospitals improve quality of life and satisfaction with care for patients with advanced disease. However, referrals to SPCTs are often limited. To identify areas for improvement of SPCTs’ service penetration, we explored the characteris...

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Autores principales:	M.S. Boddaert, A. Stoppelenburg, J. Hasselaar, Y.M. van der Linden, K.C.P. Vissers, N.J.H. Raijmakers, L. Brom
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Healthcare delivery Palliative care Consultation and referral Hospitals Cross-sectional survey Special situations and conditions RC952-1245
Acceso en línea:	https://doaj.org/article/d23191987d5c4406b06047089b40d666
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spelling	oai:doaj.org-article:d23191987d5c4406b06047089b40d6662021-11-14T12:11:57ZSpecialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands10.1186/s12904-021-00875-31472-684Xhttps://doaj.org/article/d23191987d5c4406b06047089b40d6662021-11-01T00:00:00Zhttps://doi.org/10.1186/s12904-021-00875-3https://doaj.org/toc/1472-684XAbstract Background Specialist palliative care teams (SPCTs) in hospitals improve quality of life and satisfaction with care for patients with advanced disease. However, referrals to SPCTs are often limited. To identify areas for improvement of SPCTs’ service penetration, we explored the characteristics and level of integration of palliative care programmes and SPCTs in Dutch hospitals and we assessed the relation between these characteristics and specialist palliative care referral rates. Methods We performed a secondary analysis of a national cross-sectional survey conducted among hospitals in the Netherlands from March through May 2018. For this survey, a previously developed online questionnaire, containing 6 consensus-based integration indicators, was sent to palliative care programme leaders in all 78 hospitals. For referral rate we calculated the number of annual inpatient referrals to the SPCT as a percentage of the number of total annual hospital admissions. Referral rate was dichotomized into high (≥ third quartile) and low (< third quartile). Characteristics of SPCTs with high and low referral rate were compared using univariate analyses. P-values < 0.05 were considered significant. Results In total, 63 hospitals (81%) participated in the survey, of which 62 had an operational SPCT. The palliative care programmes of these hospitals consisted of inpatient consultation services (94%), interdisciplinary staffing (61%), outpatient clinics (45%), dedicated acute care beds (21%) and community-based palliative care (27%). The median referral rate was 0.56% (IQR 0.23–1.0%), ranging from 0 to 3.7%. Comparing SPCTs with high referral rate (≥1%, n = 17) and low referral rate (< 1%, n = 45) showed significant differences for SPCTs’ years of existence, staffing, their level of education, participation in other departments’ team meetings, provision of education and conducting research. With regard to integration, significant differences were found for the presence of outpatient clinics and timing of referrals. Conclusion In the Netherlands, palliative care programmes and specialist palliative care teams in hospitals vary in their level of integration and development, with more mature teams showing higher referral rates. Appropriate staffing, dedicated outpatient clinics, education and research appear means to improve service penetration and timing of referral for patients with advanced diseases.M.S. BoddaertA. StoppelenburgJ. HasselaarY.M. van der LindenK.C.P. VissersN.J.H. RaijmakersL. BromBMCarticleHealthcare deliveryPalliative careConsultation and referralHospitalsCross-sectional surveySpecial situations and conditionsRC952-1245ENBMC Palliative Care, Vol 20, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Healthcare delivery Palliative care Consultation and referral Hospitals Cross-sectional survey Special situations and conditions RC952-1245
spellingShingle	Healthcare delivery Palliative care Consultation and referral Hospitals Cross-sectional survey Special situations and conditions RC952-1245 M.S. Boddaert A. Stoppelenburg J. Hasselaar Y.M. van der Linden K.C.P. Vissers N.J.H. Raijmakers L. Brom Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands
description	Abstract Background Specialist palliative care teams (SPCTs) in hospitals improve quality of life and satisfaction with care for patients with advanced disease. However, referrals to SPCTs are often limited. To identify areas for improvement of SPCTs’ service penetration, we explored the characteristics and level of integration of palliative care programmes and SPCTs in Dutch hospitals and we assessed the relation between these characteristics and specialist palliative care referral rates. Methods We performed a secondary analysis of a national cross-sectional survey conducted among hospitals in the Netherlands from March through May 2018. For this survey, a previously developed online questionnaire, containing 6 consensus-based integration indicators, was sent to palliative care programme leaders in all 78 hospitals. For referral rate we calculated the number of annual inpatient referrals to the SPCT as a percentage of the number of total annual hospital admissions. Referral rate was dichotomized into high (≥ third quartile) and low (< third quartile). Characteristics of SPCTs with high and low referral rate were compared using univariate analyses. P-values < 0.05 were considered significant. Results In total, 63 hospitals (81%) participated in the survey, of which 62 had an operational SPCT. The palliative care programmes of these hospitals consisted of inpatient consultation services (94%), interdisciplinary staffing (61%), outpatient clinics (45%), dedicated acute care beds (21%) and community-based palliative care (27%). The median referral rate was 0.56% (IQR 0.23–1.0%), ranging from 0 to 3.7%. Comparing SPCTs with high referral rate (≥1%, n = 17) and low referral rate (< 1%, n = 45) showed significant differences for SPCTs’ years of existence, staffing, their level of education, participation in other departments’ team meetings, provision of education and conducting research. With regard to integration, significant differences were found for the presence of outpatient clinics and timing of referrals. Conclusion In the Netherlands, palliative care programmes and specialist palliative care teams in hospitals vary in their level of integration and development, with more mature teams showing higher referral rates. Appropriate staffing, dedicated outpatient clinics, education and research appear means to improve service penetration and timing of referral for patients with advanced diseases.
format	article
author	M.S. Boddaert A. Stoppelenburg J. Hasselaar Y.M. van der Linden K.C.P. Vissers N.J.H. Raijmakers L. Brom
author_facet	M.S. Boddaert A. Stoppelenburg J. Hasselaar Y.M. van der Linden K.C.P. Vissers N.J.H. Raijmakers L. Brom
author_sort	M.S. Boddaert
title	Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands
title_short	Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands
title_full	Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands
title_fullStr	Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands
title_full_unstemmed	Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands
title_sort	specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the netherlands
publisher	BMC
publishDate	2021
url	https://doaj.org/article/d23191987d5c4406b06047089b40d666
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Specialist palliative care teams and characteristics related to referral rate: a national cross-sectional survey among hospitals in the Netherlands

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