Impacto de la identificación de pacientes en un programa de cuidados paliativos del País Vasco

Abstract

The 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.

Identification of people for palliative care in primary health care: integrative review

“…The implementation of the integrated intervention began in 2013 and was based on the identification of patients, using code 9 of the International Classification of Diseases (ICD-9), referent to PC patients. McNamara's minimum estimate was used as an identification criterion, which refers to an approach that seeks to provide minimum, average, and maximum estimates of a population in relation to the need for PC 23 .…”

“…Only the use of the PaTz method indicated a certain weakness concerning the identification of non-oncological patients 9 . PC is fitting for people in conditions that can limit one's life and should be made available as early as possible, shortly after the diagnosis, and incorporated into the disease modifying treatments 8,23 . Most people's needs at the end of life can be remedied by offering this type of early care in PHC 10 .…”

“…Individuals who present multimorbidities, weaknesses, or organ failure are still at a disadvantage in the offer of PC 8,22,23 . In general, the recognition of people who are approaching the end of life is morose, making it difficult for care planning to be put into practice 25 .…”

“…Therefore, it is of utmost importance that PHC teams adopt this care approach, fostering a broad comprehension, in addition to the formulation of therapeutic plans that can enable the optimization of the quality of life. In addition, these actions can enable better results in the establishment of targets, the coordination of care, and access to services, leading to a reduction in hospitalizations and a diminishing of unfavorable conducts during treatment, in addition to allowing more people to choose the location of their dying days and providing a greater support for the mourning of the family 9,10,23,25 .…”

“…Among the barriers to the offering of PC in PHC, what stands out is the difficulty in the systematic identification of the people who are in need of this type of care [8][9][10] . Another difficulty is the limited understanding of the people who have advanced and progressive diseases, as well as of the caretakers, about the concept and benefits of PC, associating this treatment with death, without seeing the possibility of the contribution of this care in their daily routines 8,23 .…”