Quality of care and rehospitalization rate in the last stage of disease in brain tumor patients assisted at home: a cost effectiveness study.
J Palliat Med
; 15(2): 225-7, 2012 Feb.
Article
em En
| MEDLINE
| ID: mdl-22339327
ABSTRACT
UNLABELLED Despite aggressive multimodality treatment the prognosis of patients with primary brain tumors (BT) remains poor. At present, there are no data about the role of palliative home-care services and their impact on quality of care. We report the results of a pilot project of palliative home care for BT patients started in 2000 in the National Cancer Institute Regina Elena of Rome. We report also the result of a cost/effectiveness analysis utilizing administrative data on re-hospitalization rate in the last two months of life. METHODS:
Since October 2000 until December 2009, 572 patients have been followed by our home care staff. Among 394 patients who died, 276 (70%) were followed at home until death. A cost/effectiveness analysis was carried out evaluating the rehospitalization rate in the last 2 months of life in a subgroup of patients (group 1 assisted at home, 72 patients; group 2 not assisted at home, 71). The number of hospital readmission in the last 2 months of life, and length and cost of hospitalization were retrospectively analyzed from hospital discharge records.RESULTS:
Hospitalization rate of group 1 (16.7%) was lower than group 2 (38%) (95% CI 0.18-0.65, p = 0.001). Costs of hospitalization also differed substantially 517 Euros (95% CI 512-522) in group 1 vs 24, 076 Euros (95% 24,040-24,112 Euros) in group 2.CONCLUSION:
Home-care may represent an alternative to in-hospital care for the management of brain tumor patients and may improve the end-of-life quality of care.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cuidados Paliativos
/
Qualidade da Assistência à Saúde
/
Neoplasias Encefálicas
/
Custos de Cuidados de Saúde
/
Serviços de Assistência Domiciliar
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article