Abstract:
BACKGROUND:Of deaths in high-income countries, 75% are caused by progressive advanced chronic conditions. Palliative care needs to be extended from terminal cancer to these patients. However, direct measurement of the prevalence of people in need of palliative care in the population has not been attempted. AIM:Determine, by direct measurement, the prevalence of people in need of palliative care among advanced chronically ill patients in a whole geographic population. DESIGN:Cross-sectional, population-based study. MAIN OUTCOME MEASURE:prevalence of advanced chronically ill patients in need of palliative care according to the NECPAL CCOMS-ICO(©) tool. NECPAL+ patients were considered as in need of palliative care. SETTING/PARTICIPANTS:County of Osona, Catalonia, Spain (156,807 inhabitants, 21.4% > 65 years). Three randomly selected primary care centres (51,595 inhabitants, 32.9% of County's population) and one district general hospital, one social-health centre and four nursing homes serving the patients. Subjects were all patients attending participating settings between November 2010 and October 2011. RESULTS:A total of 785 patients (1.5% of study population) were NECPAL+: mean age = 81.4 years; 61.4% female. Main disease/condition: 31.3% advanced frailty, 23.4% dementia, 12.9% cancer (ratio of cancer/non-cancer = 1/7), 66.8% living at home and 19.7% in nursing home; only 15.5% previously identified as requiring palliative care; general clinical indicators of severity and progression present in 94% of cases. CONCLUSIONS:Direct measurement of prevalence of palliative care needs on a population basis is feasible. Early identification and prevalence determination of these patients is likely to be the cornerstone of palliative care public health policies.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Gómez-Batiste X,Martínez-Muñoz M,Blay C,Amblàs J,Vila L,Costa X,Espaulella J,Espinosa J,Constante C,Mitchell GKdoi
10.1177/0269216313518266subject
Has Abstractpub_date
2014-04-01 00:00:00pages
302-11issue
4eissn
0269-2163issn
1477-030Xpii
0269216313518266journal_volume
28pub_type
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journal_title:Palliative medicine
pub_type: 杂志文章,评审
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journal_title:Palliative medicine
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