Insights from 2nd International Seminar on End-of-Life Care Preferences in Europe
The 2nd International Seminar highlighted findings on actual and preferred places of death in four European countries, emphasizing the importance of patient-centered care, societal costs, and public policies. Winne Ko presented EURO IMPACT studies showing the use of proxies and GP networks to gather information. Descriptive analyses of cancer patient preferences revealed no statistical variances across countries. The seminar also discussed the distribution of actual places of death, with notable variations between home, hospital, and care facilities.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
2nd International Seminar of the PRC and EAPC RN Actual and Preferred Place of Death in 4 European countries Winne Ko Euro Impact Fellow (IRCCS AOU San Martino-IST, Genoa, Italy) 18th Oct 2012, Ghent, Belgium IRCCS AOU San Martino - IST
2 EURO IMPACT Outline Background: studies on preference met by Winne Ko 18/10/2012 EURO SENTI-MELC 2009-2010 - methodology - analyses on preference met on place of death - results Implications for public health
3 EURO IMPACT Studies on preference met on place of death by Winne Ko 18/10/2012 Why? 1. Patients and their carers: last vivid memory 2. Healthcare professionals: patients-centred care 3. Society: costs and public policies Debate: Should the United States Ration End-of-Life Care? (http://fora.tv/2012/10/10/Debate_Should_the_U nited_States_Ration_End-of-Life_Care)
4 by Winne Ko 18/10/2012
5 EURO IMPACT How? Requires 2 pieces of information actual and preferred place of death 1. Death certificates by Winne Ko 18/10/2012 2. Use of proxies: friends and relatives / healthcare professionals
6 EURO IMPACT EURO SENTI-MELC 2009-2010 Methodology 1) Retrospective survey using general practitioners(GPs) as proxies in 4 European countries (Belgium, the Netherlands, Italy and Spain) by Winne Ko 18/10/2012 2) Sentinel GPs network used in each country 3) Standardised weekly registration form reporting patients information and care-related items: cause of death, types of care received, presence of symptoms etc
7 EURO IMPACT Descriptive study on preference met 2010 data Only cancer death patients, aged 18 with non-sudden deaths selected; nursing home deaths(NL) excluded No statistical differences on age, sex and types of malignancies by Winne Ko 18/10/2012 Country Belgium the Italy Spain Netherlands N Overall Sample 292 181 308 149 preference met analyses 129 128 81 39
8 EURO IMPACT Actual place of death (N=930) Home + hospital deaths : about 60-80% by Winne Ko 18/10/2012 100% 8% 12% 15% 20% 5% 5% 8% 80% 11% 33% 17% 38% 60% PC unit/hospices Care Home Hospital Home 34% 40% 60% 53% 45% (p<0.01) 20% 35% 0% * Belgium *Not added up to 100% due to rounding off Netherlands Italy Spain
9 EURO IMPACT Preferred place of death (N=377) GPs knowledge(N=930): 27%(IT) to 72%(NL) of GPs were informed about the preferred place of death (%) by Winne Ko 12/04/2012 100 90 90 Home 78 80 71 Care Home 60 Hospital 40 PC Unit/Hospices (p<0.01) 20 13 12 11 9 6 5 5 2 2 2 1 1 0 Belgium Netherlands Italy* Spain* *Not added up to 100% due to rounding off
10 EURO IMPACT Congruence on place of death(N=377) 100 (%) by Winne Ko 12/04/2012 95 Belgium Netherlands Italy Spain 90 85 80 75 BE: 81.4%(105) NL: 91.47%(117) IT: 67.9%(55) ES:92.3% (36) 70 65 60 Home Carehome Hospital PCU/Hospices *For Italy and Spain, numbers for deaths in care home, hospital and PCU/ hospice are small (1-5)
11 EURO IMPACT by Winne Ko 18/10/2012 When information is unavailable (N=930) BE NL IT ES known not known not known not known not known known known known 130 162 129 52 83 225 47 102 N % % % % Home 57.7 16.9 72.9 30.8 56.6 40.0 80.9 42.1 Hospital 10.8 52.5 3.9 48.1 33.7 40.0 8.5 45.0 p-value p<0.01 p<0.01 p=0.028 p<0.01
12 EURO IMPACT Summary majority of cancer patients preferred dying at home; while around one-third (except NL) died in hospitals cross-country variations on GPs awareness of patients preferred place of death; possible cultural difference level of preference met is high when GPs were informed most patients died in hospitals when GPs were not informed article under review: European Journal of Cancer by Winne Ko 18/10/2012
13 EURO IMPACT by Winne Ko 18/10/2012 Implications on public health ageing population projects an exponential need for end-of-life care trainings to healthcare professionals (communication skills, teamwork) public education: changes in social practices and accept diversities
14 by Winne Ko 18/10/2012
15 EURO IMPACT by Winne Ko 18/10/2012 THANKS ! e-mail: winne.ko@vub.ac.be Monica Beccaro, Guido Miccinesi, Viviane Van Casteren, G Donker, Bregje Onwuteaka-Philipsen, Mar a Teresa Miralles Esp , Luc Deliens, Massimo Costantini, Lieve Van den Block on behalf of EURO IMPACT EURO IMPACT, European Intersectorial and Multidisciplinary Palliative Care Research Training, is funded by the European Union Seventh Framework Programme (FP7/2007- 2013, under grant agreement nr [264697]).
