Care of cancer patients in a home-based hospice program: a comparison of oncologists and primary care physicians.
BACKGROUND
The purpose of this study was to describe a group of patients cared for in a home-based hospice program and to determine if there was a difference in patients' experiences dependent on whether the attending physician was a primary care physician or an oncologist.


METHODS
Information about cancer patients admitted to the Burlington Visiting Nurse Association (VNA) Hospice program from January 1986 to December 1990 was reviewed to compare the experiences of the patients of the oncologists with those of the patients of the primary care physicians.


RESULTS
There was no difference in average length of stay or overall ambulatory status between the patient groups. The patient group cared for by oncologists had more hospitalizations than the group cared for by primary care physicians though there was not a significant difference in the percentage of hospital vs home deaths. There was a significant difference between the groups in the use of controlled-release morphine, with oncologists using this approach more often than primary care physicians. Oncologists also had more patients on continuous parenteral morphine infusions during hospice care.


CONCLUSIONS
Primary care physicians as well as oncologists provide effective cancer care and pain control in this home-based hospice program. The hospice interdisciplinary team can be a valuable resource for physicians in supplying information on appropriate narcotics dosages and routes of administration for their dying patients.
Department of Family Practice, University of Vermont, Burlington 05405.
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Ramsay
D000328:Adult; D000367:Age Factors; D000368:Aged; D006699:Home Care Services / Q000592:standards; D017051:Hospice Care / Q000592:standards*; D006760:Hospitalization; D006801:Humans; D008495:Medical Oncology / Q000592:standards*; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage; D009369:Neoplasms / Q000503:physiopathology / Q000628:therapy*; D010146:Pain / Q000188:drug therapy; D010166:Palliative Care; D010821:Physicians, Family / Q000592:standards*; D011787:Quality of Health Care; D013997:Time Factors; D014707:Vermont
D009294:Narcotics