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Assessing quality of end-of-life hospital care in a southern European regional health service

Published online by Cambridge University Press:  25 October 2005

Elena Aldasoro ,
Adelina Pérez Alonso ,
Laureano Ribacoba ,
Santiago Esnaola ,
Maite Olaizola ,
Jose Antonio Carrera ,
Ana Bañuelos  and
Rosa Rico
Elena Aldasoro
Affiliation:
Department of Health of the Basque Government
Adelina Pérez Alonso
Affiliation:
Osakidetza/Basque Health Service
Laureano Ribacoba
Affiliation:
Mutua Vizcaya Industrial
Santiago Esnaola
Affiliation:
Department of Health of the Basque Government
Maite Olaizola
Affiliation:
Donostia Hospital
Jose Antonio Carrera
Affiliation:
Donostia Hospital
Ana Bañuelos
Affiliation:
Santa Marina Hospital
Rosa Rico
Affiliation:
Department of Health of the Basque Government
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Abstract

Objectives: During the final period of life, patients with cancer in the Basque Country are given treatment in different types of hospital care. This study compared the quality of care according to the type of care in one of the autonomous communities in Spain.

Methods: A retrospective study was carried out of cancer patients who died in conventional hospital services, home hospitalization services, and palliative care units. In addition to hospital stay and readmission number, variables based on the recommendations of Spanish Society for Palliative Care were studied.

Results: End-of-life was diagnosed in 57 percent of a sample of 486 patients, 3 days before death (median). The use of symptom control scales was only documented in the clinical records of eight patients. Sociofamily evaluation was not found. Patients in conventional hospital services were less frequently diagnosed with end-of-life and agony and were significantly different from the rest in the reasons for admission, symptoms assessed, drugs used, administration routes, and dosage forms. Pain was evaluated in 50 percent of the patients and was better controlled in palliative care units. Patients not diagnosed with agony (52 percent) were more frequently not given specific treatment.

Conclusions: End-of-life in cancer patients was diagnosed too late. The quality of care in palliative care units and by home hospitalization service was better than that in conventional hospitalization. Nevertheless, there were areas for improvement in the three modalities of care.

Keywords

Palliative careHospital careQuality of health careTerminally illHealth care surveys
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 4 , October 2005 , pp. 464 - 470
Copyright
© 2005 Cambridge University Press

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