Use of palliative care services and general practitioner visits at the end of life in The Netherlands and Belgium.
BACKGROUND
At the end of life, some personalized and specialized care is required. The way that general practitioner (GP) visits and palliative care services at the end of life are organized in different countries may impact the frequency of care provision. However, nationwide data on the prevalence of these interventions and comparisons among countries are scarce.


OBJECTIVE
To compare the frequency of GP visits and use of palliative care services at the end of life in two European countries and identify the associated factors.


METHODS
In 2007, two mortality follow-back studies were conducted simultaneously in The Netherlands and Belgium, using existing Sentinel GP networks and similar standardized procedures. Within the one-year period, all registered patients who died at home or in a care home were selected.


RESULTS
From the data of 543 registered patients, GP visits were more frequent at the end of life in The Netherlands than in Belgium: the mean number of GP visits in the last week of life was 5.1 vs. 3.2 (home) and 4.4 vs. 2.3 (care home). Conversely, palliative care services in the last three months of life were used more frequently in Belgium than in The Netherlands: 78% vs. 41% (home) and 39% vs. 5% (care homes). The differences between countries remained consistent despite correcting for possible confounders. Having more frequent GP visits at home was associated with cancer-related deaths both in The Netherlands and Belgium.


CONCLUSIONS
Independent of the differences in patient populations (at home and care home) between countries, there are more frequent GP visits at the end of life in The Netherlands and greater use of palliative care services in Belgium.
Abarshi
Ebun
E
Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands. ebun.abarshi@vumc.nl
Echteld
Michael A
MA
Van den Block
Lieve
L
Donker
Gé
G
Bossuyt
Nathalie
N
Meeussen
Koen
K
Bilsen
Johan
J
Onwuteaka-Philipsen
Bregje
B
Deliens
Luc
L
D001530:Belgium; D058005:General Practitioners / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006699:Home Care Services / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D009426:Netherlands; D010166:Palliative Care / Q000706:statistics & numerical data*; D013727:Terminal Care / Q000706:statistics & numerical data*