Evidence map›Paper›PMID 29221947›Full record

ArticleAtencion primaria2019

[The impact of patient identification on an integrated program of palliative care in Basque Country].

Igor Larrañaga, Jesús Millas, Myriam Soto-Gordoa, Arantzazu Arrospide, Ricardo San Vicente, Marisa Irizar, Itziar Lanzeta, Javier Mar

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Atencion primaria, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Igor LarrañagaUnidad de Investigación AP-OSI, OSI Alto Deba, Arrasate-Mondragón, Guipúzcoa, España. Electronic address: igor.larranagauribetxebarria@osakidetza.net.
Jesús MillasUnidad de Integración Asistencial, OSI Alto Deba, Arrasate-Mondragón, Guipúzcoa, España.
Myriam Soto-GordoaUnidad de Investigación AP-OSI, OSI Alto Deba, Arrasate-Mondragón, Guipúzcoa, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Vizcaya, España; Instituto Biodonostia, Donostia-San Sebastián, Guipúzcoa, España.
Arantzazu ArrospideUnidad de Investigación AP-OSI, OSI Alto Deba, Arrasate-Mondragón, Guipúzcoa, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Vizcaya, España; Instituto Biodonostia, Donostia-San Sebastián, Guipúzcoa, España.
Ricardo San VicenteCentro de Salud de Zumarraga, OSI Goierri-Alto Urola, Zumarraga, Guipúzcoa, España.
Marisa IrizarCentro de Salud de Idiazabal, OSI Goierri-Alto Urola, Idiazabal, Guipúzcoa, España.
Itziar LanzetaServicio de Medicina Preventiva, OSI Goierri-Alto Urola, Zumarraga, Guipúzcoa, España.
Javier MarUnidad de Investigación AP-OSI, OSI Alto Deba, Arrasate-Mondragón, Guipúzcoa, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Bilbao, Vizcaya, España; Instituto Biodonostia, Donostia-San Sebastián, Guipúzcoa, España.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveEvaluate the process and the economic impact of an integrated palliative care program.

designComparative cross-sectional study. LOCATION: Integrated Healthcare Organizations of Alto Deba and Goierri Alto-Urola, Basque Country.

participantsPatients dead due to oncologic and non-oncologic causes in 2012 (control group) and 2015 (intervention group) liable to need palliative care according to McNamara criteria.

interventionsIdentification as palliative patients in primary care, use of common clinical pathways in primary and secondary care and arrange training courses for health professionals. MAIN MEASURES: Change in the resource use profile of patients in their last 3 months. Propensity score by genetic matching method was used to avoid non-randomization bias. The groups were compared by univariate analysis and the relationships between variables were analysed by logistic regressions and generalized linear models.

resultsOne thousand and twenty-three patients were identified in 2012 and 1,142 patients in 2015. In 2015 doubled the probability of being identify as palliative patient in deaths due to oncologic (19-33%) and non-oncologic causes (7-16%). Prescriptions of opiates rise (25-68%) and deaths in hospital remained stable. Contacts per patient with primary care and home hospitalization increased, while contacts with hospital admissions decreased. Cost per patient rise 26%.

conclusionsThe integrated palliative care model increased the identification of the target population. Relationships between variables showed that the identification had a positive impact on prescription of opiates, death outside the hospital and extension to non-oncologic diseases. Although the identification decreased admissions in hospital, costs per patient had a slight increase due to home hospitalizations.

Indexed as

Patient SelectionAdultAgedAged, 80 and overCross-Sectional StudiesDelivery of Health Care, IntegratedFemaleHealth Care CostsHumansLinear ModelsLogistic ModelsMaleMiddle AgedNeeds AssessmentOutcome and Process Assessment, Health CarePalliative CareCalidad de atenciónCostCosteCriterios McNamaraCuidados paliativosIntegrated programMcNamara criteriaPalliative careProgramas integradosQuality of care

Identifiers

PMID29221947
PMCPMC6836896

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.