• Thijs Reyniers, Luc Deliens, H Roeline W Pasman, Robert Vander Stichele, Bart Sijnave, Dirk Houttekier, and Joachim Cohen.
• End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium treyniers@itg.be.
• Palliat Med. 2016 Jul 12.

BackgroundAlthough the acute hospital setting is not considered to be an ideal place of death, many people are admitted to hospital at the end of life.AimTo examine what proportion of terminal hospital admissions among their patients family physicians consider to have been avoidable and/or inappropriate; which patient, family physician and admission factors are associated with the perceived inappropriateness or avoidability of terminal hospital admissions; and which interventions could have prevented them, from the perspective of family physicians.DesignSurvey among family physicians, linked to medical record data.SettingPatients who had died non-suddenly in the acute hospital setting of a university hospital in Belgium between January and August 2014.ResultsWe received 245 completed questionnaires (response rate 70%) and 77% of those hospital deaths (n = 189) were considered to be non-sudden. Almost 14% of all terminal hospital admissions were considered to be potentially inappropriate, almost 14% potentially avoidable and 8% both, according to family physicians. The terminal hospital admission was more likely to be considered potentially inappropriate or potentially avoidable for patients who had died of cancer, when the patient's life expectancy at the time of admission was limited, by family physicians who had had palliative care training at basic, postgraduate or post-academic level, and when the admission was initiated by the patient, partner or other family.ConclusionTimely communication with the patient about their limited life expectancy and the provision of better support to family caregivers may be important strategies in reducing the number of hospital deaths.© The Author(s) 2016.

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