ArticleBMC family practice2012
End-of-life hospital referrals by out-of-hours general practitioners: a retrospective chart study.
Article in BMC family practice, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Co-designing Community Out-of-hours Palliative Care Services: A systematic literature search and review.Palliative medicine · 2023Pooled it
- Home care nurses more positive about the palliative care that is provided and their own competence than hospital nurses: a nationwide survey.BMC palliative care · 2021Article
- Article
- Role of out of hours primary care service in limiting inappropriate access to emergency department.Internal and emergency medicine · 2018Article
- End of life hospitalisations differ for older Australian women according to death trajectory: a longitudinal data linkage study.BMC health services research · 2016Article
- Cancer patients' use of primary care out-of-hours services: a cross-sectional study in Norway.Scandinavian journal of primary health care · 2016Article
- Burden for family carers at the end of life; a mixed-method study of the perspectives of family carers and GPs.BMC palliative care · 2014Article
- Reasons for hospitalisation at the end of life: differences between cancer and non-cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2014Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany patients are transferred from home to hospital during the final phase of life and the majority die in hospital. The aim of the study is to explore hospital referrals of palliative care patients for whom an out-of-hours general practitioner was called.
methodsA retrospective descriptive chart study was conducted covering a one-year period (1/Nov/2005 to 1/Nov/2006) in all eight out-of-hours GP co-operatives in the Amsterdam region (Netherlands). All symptoms, sociodemographic and medical characteristics were recorded in 529 charts for palliative care patients. Multivariate logistic regression analysis was performed to identify the variables associated with hospital referrals at the end of life.
resultsIn all, 13% of all palliative care patients for whom an out-of-hours general practitioner was called were referred to hospital. Palliative care patients with cancer (OR 5,1), cardiovascular problems (OR 8,3), digestive problems (OR 2,5) and endocrine, metabolic and nutritional (EMN) problems (OR 2,5) had a significantly higher chance of being referred. Patients receiving professional nursing care (OR 0,2) and patients for whom their own general practitioner had transferred information to the out-of-hours cooperative (OR 0,4) had a significantly lower chance of hospital referral. The most frequent reasons for hospital referral, as noted by the out-of-hours general practitioner, were digestive (30%), EMN (19%) and respiratory (17%) problems.
conclusionWhilst acknowledging that an out-of-hours hospital referral can be the most desirable option in some situations, this study provides suggestions for avoiding undesirable hospital referrals by out-of-hours general practitioners at the end of life. These include anticipating digestive, EMN, respiratory and cardiovascular symptoms in palliative care patients.
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