Palliative care in the public health system: how do physicians deal with their patients at the end of life?

International journal of palliative nursing Pub Date : 2025-01-02 DOI:10.12968/ijpn.2025.31.1.6

Ricardo Pedrini Cruz, José Américo Serafim, Daniel Klug, Cledy Eliana Dos Santos

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Abstract

Background: Patients with cancer are referred late to palliative care services (PCS).

Aim: To analyse the time of referral to PCSs and the characteristics of patients that are referred.

Methods: A retrospective cohort. All patients admitted in a single tertiary care institution were evaluated by the PCSs from February 1, 2018 to January 31, 2019.

Findings: Among the 642 patients (557 patients with cancer) referred to PCSs: 7.47% died before evaluation, 13.08% died before transfer, and 15.6% died within 8 days after transfer. Out of all the patients with cancer included in the study, 85.28% had less than 2 months of PCS follow-up during their disease. In the last 30 days of life, 96.26% had were readmitted to hospital. A total of 94.09% of patients with cancer died in a hospital.

Conclusion: These findings suggest that patients with cancer in Brazil are not referred early enough to PCSs. Early integration with PCS must be sought to improve the accuracy of referral.

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公共卫生系统中的姑息治疗：医生如何处理临终病人？

背景：晚期癌症患者转诊到姑息治疗服务（PCS）。目的：分析转诊到专科医院的时间及转诊患者的特点。方法：回顾性队列研究。2018年2月1日至2019年1月31日，所有在单一三级医疗机构入院的患者均由PCSs进行评估。结果：642例PCSs患者（557例肿瘤患者）评估前死亡7.47%，转院前死亡13.08%，转院后8天内死亡15.6%。在纳入研究的所有癌症患者中，85.28%的患者在发病期间的PCS随访时间少于2个月。在生命的最后30天，96.26%的患者再次住院。94.09%的癌症患者在医院死亡。结论：这些发现表明，巴西的癌症患者没有足够早地转诊到PCSs。必须寻求与PCS的早期整合，以提高转诊的准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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International journal of palliative nursing

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