title: Palliative home care reduces time spent in hospital wards: a population-based study in the Tuscany Region, Italy.
abstract: OBJECTIVE
  To estimate the reduction of time spent in hospital obtained through palliative home care.
  
  
  METHODS
  Retrospective analysis of the hospital admissions occurred during the last year of life. Cancer patients who were resident in the province of Florence, were registered at the Tuscan Cancer Registry, and died during the year 1997 were included in the study. Three palliative home care services were operating in the study area in 1997.
  
  
  RESULTS
  3423 cancer patients died in the study area during 1997. 9.2% of them received palliative home care. Palliative home care was effective in reducing the utilization of hospital care during the last three months of life. A 25% reduction of the relative risk (CI: 34-14%) to have in-patient admissions and a 49% reduction of relative risk (CI: 52-47%) of spending days in the hospital during the last 3 months of life were estimated through multivariable regression models.
  
  
  CONCLUSIONS
  Palliative home care was effective in reducing time spent in hospital during the last 3 months of life.
authors.affiliation: Epidemiology Unit, Center for Study and Prevention of Cancer-IRS, Florence, Italy. g.miccinesi@cspo.it
authors.forename: Guido
authors.initials: G
authors.lastname: Miccinesi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Crocetti
authors.forename: Piero
authors.initials: P
authors.lastname: Morino
authors.forename: Mauro
authors.initials: M
authors.lastname: Fallai
authors.forename: Massimo
authors.initials: M
authors.lastname: Piazza
authors.forename: Valeria
authors.initials: V
authors.lastname: Cavallini
authors.forename: Eugenio
authors.initials: E
authors.lastname: Paci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D010166:Palliative Care / Q000706:statistics & numerical data*; D012042:Registries; D012044:Regression Analysis; D012107:Research Design; D012189:Retrospective Studies; D012306:Risk; D015983:Selection Bias; D013997:Time Factors