The Association Between Timely Documentation of Advance Care Planning, Hospital Care Consumption and Place of Death: A Retrospective Cohort Study.

Autor:	Burghout C; Department of Hemato-Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.; Jeroen Bosch Academy Research, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.; Department of Tranzo, Tilburg University, School of Social and Behavioral Sciences, Tilburg, the Netherlands., Nahar-van Venrooij LMW; Jeroen Bosch Academy Research, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.; Department of Tranzo, Tilburg University, School of Social and Behavioral Sciences, Tilburg, the Netherlands., van der Rijt CCD; Department of Medical Oncology, Erasmus Medical Center Cancer Institute, Rotterdam, the Netherlands., Bolt SR; Department of Tranzo, Tilburg University, School of Social and Behavioral Sciences, Tilburg, the Netherlands., Smilde TJ; Department of Hemato-Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands., Wouters EJM; Department of Tranzo, Tilburg University, School of Social and Behavioral Sciences, Tilburg, the Netherlands.; Fontys University of Applied Science, School of Allied Health Professions, Eindhoven, the Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of palliative care [J Palliat Care] 2025 Jan; Vol. 40 (1), pp. 79-88. Date of Electronic Publication: 2024 Sep 30.
DOI:	10.1177/08258597241275355
Abstrakt:	Objectives: (1) To describe ACPT implementation frequency in practice. (2) To assess associations of ACPT documentation with a) hospital care consumption, including systemic anti-tumor treatment in the last month(s) of life, and b) match between preferred and actual place of death, among oncology patients. Methods: A retrospective cohort study was performed. Data concerning ACPT documentation, hospital care consumption, and preferred and actual place of death were extracted from electronic patient records. Patients with completely documented ACPT (cACPT) and no ACPT were compared using multivariable logistic regression analyses. Results: ACPT was implemented in 64.5% (n = 793) of all deceased patients (n = 1230). In 17.6% (n = 216), preferred place of care or death was documented at least three months before death (cACPT). A cACPT was not associated with systemic anti-tumor treatment (Adjusted OR (AOR): 0.976; 95% CI: 0.642-1.483), but patients with cACPT had fewer diagnostic tests (AOR: 0.518; CI: 0.298-0.903) and less contacts with hospital disciplines (AOR: 0.545; CI: 0.338-0.877). In patients with cACPT, a match between preferred and actual place of death was found for 83% of the patients for whom the relevant information was available (n = 117/n = 141). In patients without ACPT, this information was mostly missing. Conclusion: Although the ACPT was implemented in two thirds of patients, timely documentation of preferred place of care or death is often missing. Yet, timely documentation of these preferences may promote out-hospital-death and save hospital care consumption. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu