Articles: palliative-care.
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J Pain Symptom Manage · Jun 2006
Multicenter StudyResource consumption and costs of palliative care services in Spain: a multicenter prospective study.
Patients (n=395) with terminal-stage cancer receiving attention from palliative care services (PCSs) were recruited over a period of 15 consecutive days from 171 participating PCS units. Resource consumption and costs were evaluated for 16 weeks of follow-up, and the findings were compared with a study conducted in 1992 so as to assess change over time. ⋯ Compared with the historical data, there was a significant shift from the use of conventional hospital beds toward palliative care beds, a reduced hospital stay (25.5-19.2 days; P=0.002), an increase in the death-at-home option (31%-42%), a lower use of hospital emergency rooms (52%-30.6%; P=0.001), and an increase in programmed care. Compared to the previous resource consumption and expenditure study in 1992, the current PCS policy implies a cost saving of 61%, with greater efficiency and no compromise of patient care.
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Support Care Cancer · Apr 2006
Multicenter StudyEuroQol and survival prediction in terminal cancer patients: a multicenter prospective study in hospice-palliative care units.
Although the EuroQol (EQ-5D) is widely used for economic evaluation, it remains unclear whether it can be combined with medical data to predict survival in patients with terminal cancer. ⋯ The EQ-5D quality-of-life assessment tool might be useful for predicting survival time for terminal cancer patients.
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Dtsch. Med. Wochenschr. · Mar 2006
Multicenter Study Comparative Study[Adjuvant and palliative chemotherapy of colorectal cancer in Germany outside controlled trials].
Colorectal cancer is the second most common malignant tumour in Germany with an unfavorable prognosis especially in a locally advanced or metastasizing stage. Although adjuvant and palliative chemotherapy significantly improve 5-year survival, consensus recommendations have in the past been inadequately transformed into clinical practice. It was the aim of this study to analyse the implementation of existing guidelines in a cohort from a defined area of Germany. ⋯ Stage III colon cancer was predominantly treated according to the existing standard guidelines. In contrast combined radio- and chemotherapy for rectal cancer stage II and III was only performed in one third of the patients, another third receiving neither adjuvant radiation nor chemotherapy. Initial combined or sequential combined chemotherapy for metastasizing colorectal cancer was rarely performed.
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Multicenter Study Comparative Study
Quality of life of cancer patients receiving inpatient and home-based palliative care.
This paper reports a comparative study of the symptom experience, physical and psychological health, perceived control of the effects of cancer and quality of life of terminally ill cancer patients receiving inpatient and home-based palliative care, and the factors that predict quality of life. ⋯ The main issues arising from the findings for nurses are the early detection and management of both physical and psychological symptoms, particularly fatigue, pain, anxiety and depression, and the need to use strategies that will empower patients to have a greater sense of control over their illness and treatment. Research is needed to identify other factors that may impact on quality of life, and to establish the extent to which inpatient and home-based care meets the needs of both the patient with terminal cancer and their family.
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Palliative medicine · Mar 2006
Multicenter StudyDeterminants of resource utilization in four palliative care units.
To assess resources mobilized per day and per patient receiving palliative care (PC) and to explain the observed cost variability. ⋯ These elements suggest using, not a single rate to finance this type of care, but modifying this tariff according to the characteristics of the patients. They raise the question about the criteria to be used if such a step were to be taken.