[Problems and deficits in the transition from inpatient to outpatient care of cancer patients].
BACKGROUND
Initiated by the Public Health Department of the City of Aachen problems and deficits in the transition from hospital-based to outpatient care of cancer patients were evaluated.


METHODS
From September 2002 to April 2003 the data of 145 cancer patients who met the inclusion criteria and had been treated in four regional hospitals were collected by questionnaire, phone and personal interview at four different points in time within a period of six to eight weeks and documented. Aspects of interest included: type of disease, symptom burden, well-being, home care situation and medical aids required.


RESULTS
Problems and deficits in the transition from hospital-based to outpatient care of cancer patients were only infrequently encountered. Specific structural deficits or general problems were not identified. The majority of patients felt comfortable with their medical transition process. For a special subgroup of patients who died during the trial period worse outcomes were documented than for the whole sample.


CONCLUSIONS
Worse outcomes of the dying patients indicate disease progression with reduced quality of life, higher symptom burden and less satisfaction. The complex study method and the resulting selection bias may have contributed to underestimating transition problems. A more simple method could reduce the burden for the patients and the amount of missing data and thus allow for a deeper insight into the patients' needs.
Stiel
Stephanie
S
Klinik für Palliativmedizin, Universitätsklinikum RWTH Aachen. sstiel@ukaachen.de
Joppich
Robin
R
Nachite
Salima
S
Elsner
Frank
F
Radbruch
Lukas
L
Rossaint
Rolf
R
D000553:Ambulatory Care / Q000191:economics; D001007:Anxiety; D004282:Documentation; D004644:Emotions; D005858:Germany; D006699:Home Care Services / Q000191:economics; D006801:Humans; D007297:Inpatients; D009369:Neoplasms / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D010045:Outpatients; D010166:Palliative Care / Q000191:economics; D017060:Patient Satisfaction; D012040:Regional Health Planning / Q000592:standards; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000191:economics; D016896:Treatment Outcome