Monitoring the Italian Home Palliative Care Services

Scaccabarozzi, Gianlorenzo; Lovaglio, Pietro Giorgio; Limonta, Fabrizio; Peruselli, Carlo; Bellentani, Maria Donata; Crippa, Matteo

doi:10.3390/healthcare7010004

Cited by 12 publications

(7 citation statements)

References 21 publications

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“…The Italian National Healthcare System is tax-funded, both by public and private providers, and mainly managed by 21 Regions and the autonomous provinces. Each region then has its Local Health Agencies (ASLs), which are in charge of providing care in hospitals, at home and in residential structures for older people [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Organizational Support Experiences of Care Home and Home Care Staff in Sweden, Italy, Germany and the United Kingdom during the COVID-19 Pandemic

Lethin

Kenkmann

Chiatti³

et al. 2021

Healthcare

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The COVID-19 pandemic has affected care workers all over the globe, as older and more vulnerable people face a high risk of developing severe symptoms and dying from the virus infection. The aim of this study was to compare staff experiences of stress and anxiety as well as internal and external organizational support in Sweden, Italy, Germany, and the United Kingdom (UK) in order to determine how care staff were affected by the pandemic. A 29-item online questionnaire was used to collect data from care staff respondents: management (n = 136), nurses (n = 132), nursing assistants (n = 195), and other healthcare staff working in these organizations (n = 132). Stress and anxiety levels were highest in the UK and Germany, with Swedish staff showing the least stress. Internal and external support only partially explain the outcomes. Striking discrepancies between different staff groups’ assessment of organizational support as well as a lack of staff voice in the UK and Germany could be key factors in understanding staff’s stress levels during the pandemic. Structural, political, cultural, and economic factors play a significant role, not only factors within the care organization or in the immediate context.

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Section: Introductionmentioning

confidence: 99%

Organizational Support Experiences of Care Home and Home Care Staff in Sweden, Italy, Germany and the United Kingdom during the COVID-19 Pandemic

Lethin

Kenkmann

Chiatti³

et al. 2021

Healthcare

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“…Los indicadores de resultado miden el éxito de la atención en salud brindada al paciente (14). Se incluyeron 24 indicadores que fueron extraídos de 8 artículos (16)(17)(18)20,(22)(23)(24)(25), uno de los indicadores presento 5 formas de ser medido. Los indicadores mencionados con mayor frecuencia fueron: porcentaje de muerte en el hogar, presencia de dolor disruptivo aun con medicación, presencia de angustia en el cuidador, prevalencia de estado de ánimo negativo y presencia de aislamiento social.…”

Section: Indic Adores De Results Adounclassified

Evaluación de la calidad de los servicios de cuidados paliativos domiciliarios: revisión de la literatura

Mejia¹,

Salcedo

Martínez

et al. 2020

Rev. Colomb. Enferm.

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Introducción: La calidad de los servicios de salud se mide con indicadores que permiten encontrar oportunidades de mejora, datos clínicos y no clínicos de relevancia, información epidemiológica y calidad percibida del servicio brindado. Los cuidados paliativos pueden ofrecerse en distintas modalidades, siendo los cuidados domiciliarios una ruta novedosa que permite el cuidado del paciente lejos del intervencionismo hospitalario; los indicadores que evalúan la calidad de esta modalidad varían respecto a los servicios intramurales. Objetivo: describir los indicadores de calidad en salud utilizados para evaluar los servicios de cuidados paliativos domiciliarios según la literatura consultada. Método: revisión sistemática de la literatura científica disponible sobre los indicadores de calidad en salud para los cuidados paliativos domiciliarios. Para valorar la calidad metodológica se usó la lista CASPe. Resultados: se encontraron 47 indicadores que evalúan la calidad de los servicios de atención domiciliaria paliativa, siendo los indicadores de resultados los que tuvieron mayor presencia. Dentro de los indicadores se midieron diversos aspectos de los cuidados paliativos como manejo de síntomas, visitas domiciliarias por personal especializado, lugar de muerte elegido, eventos relacionados con la seguridad del paciente y disponibilidad de medicamentos. Conclusiones: La medición del lugar de fallecimiento y la presencia de síntomas aun con un tratamiento farmacológico establecido fueron dos de los indicadores más encontrados. Se observó una medición al personal médico y enfermero superior al resto de profesionales que conforman el equipo multidisciplinario de cuidados paliativos, se encontraron algunos indicadores específicos para pacientes con patologías oncológicas.

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“…Moreover, proximity to a specialised palliative care centre increases patients' chances of accessing it. This indicates a need to plan specialised palliative care service implementation based on the density and characteristics of the population, taking into consideration the barriers facing the primary care offered by general practitioners (GPs) and community nurses [47,48].…”

Section: Discussionmentioning

confidence: 99%

Inequity in palliative care service full utilisation among patients with advanced cancer: a retrospective Cohort study

D’Angelo¹,

Nitto

Giannarelli

et al. 2020

Acta Oncologica

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Background: Advanced cancer patients often die in hospital after receiving needless, aggressive treatment. Although palliative care improves symptom management, barriers to accessing palliative care services affect its utilisation, and such disparities challenge the equitable provision of palliative care. This study aimed to identify which factors are associated with inequitable palliative care service utilisation among advanced cancer patients by applying the Andersen Behavioural Model of Health Services Use. Material and methods: This was a retrospective cohort study using administrative healthcare data. A total of 13,656 patients residing in the Lazio region of Italy, who died of an advanced cancer-related cause-either in hospital or in a specialised palliative care facility-during the period of 2012-2016 were included in the study. Potential predictors of specialised palliative service utilisation were explored by grouping the following factors: predisposing factors (i.e., individuals' characteristics), enabling factors (i.e., systemic/structural factors) and need factors (i.e., type/severity of illness). Results: The logistic hierarchical regression showed that older patients (odds ratio [OR] ¼ 1.45; <0.0001) of Caucasian ethnicity (OR ¼ 4.17; 0.02), with a solid tumour (OR ¼ 1.87; <0.0001) and with a longer survival time (OR ¼ 2.09; <0.0001) were more likely to be enrolled in a palliative care service. Patients who lived farther from a specialised palliative care facility (OR ¼ 0.13; <0.0001) and in an urban area (OR ¼ 0.58; <0.0001) were less likely to be enrolled. Conclusion:This study found that socio-demographic (age, ethnicity), clinical (type of tumour, survival time) and organisational (area of residence, distance from service) factors affect the utilisation of specialised palliative care services. The fact that service utilisation is not only a function of patients' needs but also of other aspects demonstrates the presence of inequity in access to palliative care among advanced cancer patients.

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Monitoring the Italian Home Palliative Care Services

Cited by 12 publications

References 21 publications

Organizational Support Experiences of Care Home and Home Care Staff in Sweden, Italy, Germany and the United Kingdom during the COVID-19 Pandemic

Organizational Support Experiences of Care Home and Home Care Staff in Sweden, Italy, Germany and the United Kingdom during the COVID-19 Pandemic

Evaluación de la calidad de los servicios de cuidados paliativos domiciliarios: revisión de la literatura

Inequity in palliative care service full utilisation among patients with advanced cancer: a retrospective Cohort study

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