End-of-life care in hospital: a descriptive study of all inpatient deaths in 1 year

@article{Abel2009EndoflifeCI,
  title={End-of-life care in hospital: a descriptive study of all inpatient deaths in 1 year},
  author={Julian Abel and A Rich and Thomas Griffin and Sarah Purdy},
  journal={Palliative Medicine},
  year={2009},
  volume={23},
  pages={616 - 622}
}
The objectives of this study are to ascertain how many patients who died in a district general hospital in England might have been able to be cared for at home, to obtain the cost of each inpatient stay, to make an estimate of the maximum resource implications of care packages for these patients, and to calculate the savings in hospital admissions that could be used for the development of community services. These objectives are dependant on full implementation of the End of Life Strategy. A… 
View on SAGE
londonprogrammes.nhs.uk
63 Citations
Highly Influential Citations
1
Background Citations
13
Methods Citations
1
Results Citations
1

63 Citations

Citation Type

Citation Type

Economic impact of hospitalisations among patients in the last year of life: An observational study
TLDR
Reducing length of hospital stay in palliative care patients may offer the potential to achieve higher hospital cost savings than preventing avoidable admissions, according to a retrospective case note review with economic impact assessment.
The extent and cost of potentially avoidable admissions in hospital inpatients with palliative care needs: a cross-sectional study
TLDR
A significant proportion of patients with palliative care needs experience a potentially avoidable hospital admission, which impacts on the experiences of patients and families and may contribute to unnecessary hospital expenditure.
The impact of advance care planning of place of death, a hospice retrospective cohort study
TLDR
ACP can be used routinely in a hospice setting and is associated with a reduction in the number of days in hospital in the last year of life with less hospital costs, supporting the assumptions made in the End of Life Care Strategy 2008.
What is the extent of potentially avoidable admissions amongst hospital inpatients with palliative care needs?
TLDR
The findings challenge assumptions that, within the existing configuration of palliative and end of life health and social care services, patients with palliatives care needs experience a high level of potentially avoidable hospitalisations.
Understanding Hospital Admissions Close to the End of Life (ACE) Study
TLDR
How decisions that result in inpatient admissions close to death are made and valued from the perspective of the decision-maker is explored, and the implications of these findings for current policy and practice are considered.
Economic analysis of potentially avoidable hospital admissions in patients with palliative care needs
TLDR
It is suggested that 7% of patients with palliative care needs could have been cared for elsewhere and the estimated cost saving of avoiding these admissions and supporting these patients in the community was £1527 for both hospitals over the survey period.
Reasons for hospitalisation at the end of life: differences between cancer and non-cancer patients
TLDR
Respiratory problems were the most common reasons for hospitalisation in the group of patients as a whole, and Digestive problems were a frequent reason forhospitalisation in cancer patients and cardiovascular symptoms in non-cancer patients.
Dying in hospital in Ireland; an assessment of the quality of care in the last week of life. Report 5, final synthesis report
TLDR
The audit identified significant weaknesses in how the hospital system responds at each stage of the patient’s journey from admission through to death, demonstrating the scope for improvement that already exists, and that better and best are possible and within reach.
Extent of palliative care need in the acute hospital setting: A survey of two acute hospitals in the UK
TLDR
The results reveal that according to the GSF prognostic guide, over a third of hospital in-patients meet the criteria for palliative care need, and draws into question the utility of the G SF in the hospital setting.
Palliative care for frail older people: A cross-sectional survey of patients at two hospitals in England
TLDR
The results suggest that older people with frailty conditions constitute a substantial proportion of hospital inpatients with palliative care needs, however, it is unclear whether a specialist palliatives care framework is the most appropriate model for this group.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 11 REFERENCES
Improving generalist end of life care: national consultation with practitioners, commissioners, academics, and service user groups
TLDR
A national consultation and prioritising exercise using a modified form of the nominal group technique to identify major concerns of national and local importance in the provision, commissioning, research, and use of generalist end of life care.
Factors influencing death at home in terminally ill patients with cancer: systematic review
TLDR
The relative influence of different factors on place of death in patients with cancer is determined to focus on ways of empowering families and public education, as well as intensifying home care, risk assessment, and training practitioners in end of life care.
Place of care in advanced cancer: a qualitative systematic literature review of patient preferences.
TLDR
Home care is the most common preference, with inpatient hospice care as second preference in advanced illness, and study designs in this area need to be improved.
Determinants of Congruence between the Preferred and Actual Place of Death for Terminally Ill Cancer Patients
TLDR
It is confirmed that the degree of congruence between the preferred and actual place death is unsatisfactory and clinical interventions and health policies need to be developed to assist terminally ill cancer patients who may not be able to achieve their preference for place of end-of-life care and death.
Analysis of the sensitivity of death certificates in 440 hospital deaths: a comparison with necropsy findings.
TLDR
There is a substantial discrepancy between the diagnosis given on death certificates compared with that at hospital necropsy, and the importance of clinicopathological concordance is emphasised.
A systematic review of discharge coding accuracy.
TLDR
Coding accuracy on average is high in the United Kingdom, especially for operations and procedures, however, policy-makers, planners and researchers need to recognize and account for the degree of inaccuracy in routine hospital information statistics.
Where people die (1974—2030): past trends, future projections and implications for care
TLDR
The projections underline the urgent need for planning care to accommodate a large increase of ageing and deaths, and suggest either inpatient facilities must increase substantially, or many more people will need community end of life care from 2012 onwards.
End-of-life care.
TLDR
Organizations advocate for clinician accountability for quality of end-of-life care and professionals and public troubled by current patterns of end of life care concerned about quality of care.
Improving choice at end of life
Place of care in advanced cancer : a qualitative systematic review of patient preferences
  • End of life care
  • 2008
...
1
2
...