Does persistent involvement by the GP improve palliative care at home for end-stage cancer patients?
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Does persistent involvement by the GP improve palliative care at home for end-stage cancer patients? / Aabom, Birgit; Kragstrup, Jakob; Vondeling, Hindrik; Bakketeig, Leiv S.; Stovring, Henrik.
I: Palliative Medicine, Bind 20, Nr. 5, 2006, s. 507-512.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Does persistent involvement by the GP improve palliative care at home for end-stage cancer patients?
AU - Aabom, Birgit
AU - Kragstrup, Jakob
AU - Vondeling, Hindrik
AU - Bakketeig, Leiv S.
AU - Stovring, Henrik
PY - 2006
Y1 - 2006
N2 - Objective: To analyse the effect of GP home visits on the granting of a terminal declaration (TD) and on place of death. Participants and desig n: A total of 2025 patients with cancer as the primary cause of death in the period 1997-1998, were investigated in a mortality follow-back design using the Danish Cancer Register and four administrative registers. The Danish TD can be issued by a physician for patients with an estimated prognosis of six months or less. The TD gives the right to economic benefits and increased care for the dying patient. Setting: The island of Funen/Denmark. Main outcome measures: Main out come - hospital death. Intermediate outcome - TD. Results: A total of 38% of patients received a TD and 56% died in hospital. GP home visits in the week before TD (odds ratio (OR): 16.8; 95% CI: 8.2-34.4), as well as four weeks before TD (OR: 6.4; 95% CI: 4.5-9.2) were associated with an increased likelihood of receiving a TD. GP home visits in the group with TD (OR: 0.18; 95% CI: 0.11-0.29) and the group without TD (OR: 0.08; 95% CI: 0.05-0.13) was inversely associated with hospital death. A dose-response relationship was found in both groups. Conclusion: Persistent involvement by the GP is associated with improved end-of-life care for cancer patients. Provided that temporal relations are taken into account, the mortality follow-back design can be a suitable and ethical research method to highlight and monitor end-of-life cancer care.
AB - Objective: To analyse the effect of GP home visits on the granting of a terminal declaration (TD) and on place of death. Participants and desig n: A total of 2025 patients with cancer as the primary cause of death in the period 1997-1998, were investigated in a mortality follow-back design using the Danish Cancer Register and four administrative registers. The Danish TD can be issued by a physician for patients with an estimated prognosis of six months or less. The TD gives the right to economic benefits and increased care for the dying patient. Setting: The island of Funen/Denmark. Main outcome measures: Main out come - hospital death. Intermediate outcome - TD. Results: A total of 38% of patients received a TD and 56% died in hospital. GP home visits in the week before TD (odds ratio (OR): 16.8; 95% CI: 8.2-34.4), as well as four weeks before TD (OR: 6.4; 95% CI: 4.5-9.2) were associated with an increased likelihood of receiving a TD. GP home visits in the group with TD (OR: 0.18; 95% CI: 0.11-0.29) and the group without TD (OR: 0.08; 95% CI: 0.05-0.13) was inversely associated with hospital death. A dose-response relationship was found in both groups. Conclusion: Persistent involvement by the GP is associated with improved end-of-life care for cancer patients. Provided that temporal relations are taken into account, the mortality follow-back design can be a suitable and ethical research method to highlight and monitor end-of-life cancer care.
KW - Cancer
KW - GP
KW - Mortality follow-back study
KW - Palliative care
KW - Place of death
KW - Population-based
UR - http://www.scopus.com/inward/record.url?scp=33746871498&partnerID=8YFLogxK
U2 - 10.1191/0269216306pm1169oa
DO - 10.1191/0269216306pm1169oa
M3 - Journal article
C2 - 16903404
AN - SCOPUS:33746871498
VL - 20
SP - 507
EP - 512
JO - Palliative Medicine
JF - Palliative Medicine
SN - 0269-2163
IS - 5
ER -
ID: 324141297