Palliative home care reduces time spent in hospital wards: a population-based study in the Tuscany Region, Italy.
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.
Miccinesi
Guido
G
Epidemiology Unit, Center for Study and Prevention of Cancer-IRS, Florence, Italy. g.miccinesi@cspo.it
Crocetti
Emanuele
E
Morino
Piero
P
Fallai
Mauro
M
Piazza
Massimo
M
Cavallini
Valeria
V
Paci
Eugenio
E
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