ArticleBMC palliative care2015
Impact of a hospice rapid response service on preferred place of death, and costs.
Article in BMC palliative care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- How is community based 'out-of-hours' care provided to patients with advanced illness near the end of life: A systematic review of care provision.Palliative medicine · 2023Pooled it
- Co-designing Community Out-of-hours Palliative Care Services: A systematic literature search and review.Palliative medicine · 2023Pooled it
- Levels and Determinants of Place-Of-Death Congruence in Palliative Patients: A Systematic Review.Frontiers in psychology · 2021Pooled it
- Duration of palliative care before death in international routine practice: a systematic review and meta-analysis.BMC medicine · 2020Pooled it
- Hospice at Home services in England: a national survey.BMJ supportive & palliative care · 2021Article
- The roles, responsibilities and practices of healthcare assistants in out-of-hours community palliative care: A systematic scoping review.Palliative medicine · 2020Article
- Optimum hospice at home services for end-of-life care: protocol of a mixed-methods study employing realist evaluation.BMJ open · 2018Article
- The Hospice Information System and its association with the congruence between the preferred and actual place of death.Tzu chi medical journalArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundMany people with a terminal illness would prefer to die at home. A new palliative rapid response service (RRS) provided by a large hospice provider in South East England was evaluated (2010) to provide evidence of impact on achieving preferred place of death and costs. The RRS was delivered by a team of trained health care assistants and available 24/7. The purpose of this study was to (i) compare the characteristics of RRS users and non-users, (ii) explore differences in the proportions of users and non-users dying in the place of their choice, (iii) monitor the whole system service utilisation of users and non-users, and compare costs.
methodsAll hospice patients who died with a preferred place of death recorded during an 18 month period were included. Data (demographic, preferences for place of death) were obtained from hospice records. Dying in preferred place was modelled using stepwise logistic regression analysis. Service use data (period between referral to hospice and death) were obtained from general practitioners, community providers, hospitals, social services, hospice, and costs calculated using validated national tariffs.
resultsOf 688 patients referred to the hospice when the RRS was operational, 247 (35.9%) used it. Higher proportions of RRS users than non-users lived in their own homes with a co-resident carer (40.3% vs. 23.7%); more non-users lived alone or in residential care (58.8% vs. 76.3%). Chances of dying in the preferred place were enhanced 2.1 times by being a RRS user, compared to a non-user, and 1.5 times by having a co-resident carer, compared to living at home alone or in a care home. Total service costs did not differ between users and non-users, except when referred to hospice very close to death (users had higher costs).
conclusionsUse of the RRS was associated with increased likelihood of dying in the preferred place. The RRS is cost neutral.
trial registrationCurrent controlled trials ISRCTN32119670, 22 June 2012.
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