ArticleBMC palliative care2018
End-of-life decisions guiding the palliative care of cancer patients visiting emergency department in South Western Finland: a retrospective cohort study.
Article in BMC palliative care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Assessing the Impact of Specialist Palliative Care on Healthcare Utilisation at the End of Life Among Patients With Pancreatic Cancer: A Nationwide Register-Based Cohort Study.Cancer medicine · 2026Article
- Effect of palliative care decisions making on hospital service use at end-of-life in patients with malignant brain tumors: a retrospective study.BMC palliative care · 2023Article
- Characteristics and factors associated with mortality in palliative patients visiting the Emergency Department of a large tertiary hospital in Thailand.BMC palliative care · 2022Observational
- Accessibility of information on patients' and family members' end-of-life wishes in advance care planning.Nursing open · 2022Article
- The impact of the duration of the palliative care period on cancer patients with regard to the use of hospital services and the place of death: a retrospective cohort study.BMC palliative care · 2020Article
- Barriers to the composition and implementation of advance directives in oncology: a literature review.Ecancermedicalscience · 2019Review
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Authors and funding
4 authors.
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Abstract
backgroundUntil recently, palliative care (PC) resources in Finland have been sparse. To meet the increasing need for PC an end-of-life (EOL) care project has been ongoing in South Western Finland since 2012, and in 2015, a weekday palliative outpatient clinic was established in Turku University Hospital (TUH). The aim of this study was to explore the effect of the project and the PC clinic on the management practices of EOL cancer patients attending the Emergency Department (ED) of TUH from 2013 to 2016.
methodsThe medical records of all cancer patients (ICD-10 codes C00-97) admitted to the ED of TUH between August 1-December 31, in 2013 and 2016, were analyzed: n = 529, n = 432 respectively (2013 and 2016). The analysis focused on those patients in EOL care; n = 77, n = 63, respectively. The late palliative patients were defined by PC decision, thus termination of life-prolonging cancer-specific treatments. The EOL patients were in the imminently dying phase of their illness. The site of referral after an ED visit was also verified together with the documentation on advance care plans (ACP), and the impact of palliative outpatient visits.
resultsIn 2016, the number of late palliative and EOL patients admitted to the ED has shown a tendency to decrease. The quality of the documentation for treatment goals, do-not-resuscitate (DNR) orders, living wills and connections to primary care providers has improved since 2013. Prior visits to palliative outpatient clinic correlated well with the more comprehensive ACP information: i) DNR order (p = 0.0001); ii) connection to primary care (p = 0.003); iii) documented ICD-10 code Z51.5 (p = 0.0001).
conclusionsEven modest investments in resources for PC can induce an objective change in the allocation of health care resources, and improve the ACP for the cancer patients at their EOL. A visit to a palliative outpatient clinic may offer one approach for improving the quality and completion of ACP documentation.
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