Susanna Böling, Hanna Gyllensten, My Engström, Emma Lundberg, Johan Berlin, Joakim Öhlén
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Research on general populations spanning all disease groups and multiple healthcare contexts is needed.</p><p><strong>Objective: </strong>The objective was to investigate the sociodemographic, disease- and care-related, and care structure-related factors associated with palliative care consultations for adult patients in the last week of life.</p><p><strong>Design: </strong>Cross-sectional, general population-level study based on linked Swedish national public authority registers and a national palliative care quality register.</p><p><strong>Methods: </strong>The study population included all adult patients deceased in Sweden between 2013 and 2019 and registered in the Swedish Register of Palliative Care, with an anticipated death, and not enrolled in specialised palliative care. Multivariable logistic regression analyses to investigate association with palliative care consultations.</p><p><strong>Results: </strong>In total, 8.2% of the 265,129 participants had received a palliative care consultation in the last week of life. The main multivariable analysis (Model 1) showed that those dying from neoplasms were more likely to receive a palliative care consultation (odds ratio (OR) 8.55, 95% CI 8.15-8.98) than those dying from circulatory diseases. Palliative care consultation was more likely with an increasing number of symptoms (OR 1.35, CI 1.32-1.37). Patients of old age and patients deceased in hospitals were less likely to receive a palliative care consultation. Moreover, factors such as educational attainment, healthcare region, living in a single-person household, and year of death were also associated with a palliative care consultation in the last week of life.</p><p><strong>Conclusion: </strong>Our findings show inequities in access to palliative care consultations in the last week of life. Considering changes to policy and clinical practice is motivated.</p>","PeriodicalId":36693,"journal":{"name":"Palliative Care and Social Practice","volume":null,"pages":null},"PeriodicalIF":2.7000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549695/pdf/","citationCount":"0","resultStr":"{\"title\":\"Palliative care consultation in the last week of life and associated factors: a cross-sectional general population study.\",\"authors\":\"Susanna Böling, Hanna Gyllensten, My Engström, Emma Lundberg, Johan Berlin, Joakim Öhlén\",\"doi\":\"10.1177/26323524241293818\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Knowledge of access to palliative care services, such as palliative care consultation teams, is crucial to identify areas of improvement for policy and practice. 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Multivariable logistic regression analyses to investigate association with palliative care consultations.</p><p><strong>Results: </strong>In total, 8.2% of the 265,129 participants had received a palliative care consultation in the last week of life. The main multivariable analysis (Model 1) showed that those dying from neoplasms were more likely to receive a palliative care consultation (odds ratio (OR) 8.55, 95% CI 8.15-8.98) than those dying from circulatory diseases. Palliative care consultation was more likely with an increasing number of symptoms (OR 1.35, CI 1.32-1.37). Patients of old age and patients deceased in hospitals were less likely to receive a palliative care consultation. 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引用次数: 0
摘要
背景：了解姑息关怀服务（如姑息关怀咨询团队）的可及性对于确定政策和实践的改进领域至关重要。需要对跨越所有疾病群体和多种医疗环境的普通人群进行研究：目的：调查与成年患者生命最后一周的姑息关怀咨询相关的社会人口学、疾病和护理相关以及护理结构相关因素：设计：基于瑞典国家公共机构登记簿和国家姑息治疗质量登记簿的横断面普通人群研究：研究人群包括2013年至2019年期间在瑞典死亡、在瑞典姑息治疗登记册上登记的所有成年患者，这些患者预计会死亡，且未参加专门的姑息治疗。通过多变量逻辑回归分析研究与姑息治疗咨询的关联：在 265 129 名参与者中，共有 8.2% 的人在生命的最后一周接受过姑息关怀咨询。主要的多变量分析（模型1）显示，与循环系统疾病患者相比，死于肿瘤的患者更有可能接受姑息关怀咨询（几率比（OR）8.55，95% CI 8.15-8.98）。症状越多，接受姑息治疗咨询的可能性越大（OR 1.35，CI 1.32-1.37）。老年患者和在医院去世的患者接受姑息治疗咨询的可能性较低。此外，教育程度、医疗保健地区、居住在单人家庭以及死亡年份等因素也与生命最后一周接受姑息关怀咨询有关：我们的研究结果表明，在生命的最后一周，获得姑息关怀咨询的机会并不平等。考虑改变政策和临床实践是有积极意义的。
Palliative care consultation in the last week of life and associated factors: a cross-sectional general population study.
Background: Knowledge of access to palliative care services, such as palliative care consultation teams, is crucial to identify areas of improvement for policy and practice. Research on general populations spanning all disease groups and multiple healthcare contexts is needed.
Objective: The objective was to investigate the sociodemographic, disease- and care-related, and care structure-related factors associated with palliative care consultations for adult patients in the last week of life.
Design: Cross-sectional, general population-level study based on linked Swedish national public authority registers and a national palliative care quality register.
Methods: The study population included all adult patients deceased in Sweden between 2013 and 2019 and registered in the Swedish Register of Palliative Care, with an anticipated death, and not enrolled in specialised palliative care. Multivariable logistic regression analyses to investigate association with palliative care consultations.
Results: In total, 8.2% of the 265,129 participants had received a palliative care consultation in the last week of life. The main multivariable analysis (Model 1) showed that those dying from neoplasms were more likely to receive a palliative care consultation (odds ratio (OR) 8.55, 95% CI 8.15-8.98) than those dying from circulatory diseases. Palliative care consultation was more likely with an increasing number of symptoms (OR 1.35, CI 1.32-1.37). Patients of old age and patients deceased in hospitals were less likely to receive a palliative care consultation. Moreover, factors such as educational attainment, healthcare region, living in a single-person household, and year of death were also associated with a palliative care consultation in the last week of life.
Conclusion: Our findings show inequities in access to palliative care consultations in the last week of life. Considering changes to policy and clinical practice is motivated.
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