title: Reasons for hospitalisation at the end of life: differences between cancer and non-cancer patients.
abstract: OBJECTIVE
  Many patients are hospitalised during the final phase of life, even though most prefer to receive care at home until the end. This study aimed to explore the reasons and characteristics of hospitalisation in the final 3 months of life for patients who died non-suddenly, with a comparison between cancer patients and non-cancer patients.
  
  
  METHODS
  This study used a nationwide retrospective cross-sectional survey among Dutch general practitioners.
  
  
  RESULTS
  Of the 317 hospitalised patients, 65 % had cancer. Most common reasons for hospitalisation in the final 3 months of life were respiratory symptoms (31 %), digestive symptoms (17 %), and cardiovascular symptoms (17 %). Seventy-three percent of patients experienced an acute episode before hospitalisation, and for 46 % of patients, their own GP initiated the hospitalisation. Compared to non-cancer patients, cancer patients were significantly more likely to be aged less than 80 (81 versus 46 %), were more likely to be hospitalised because of digestive symptoms (22 versus 7 %), were less likely to have a curative treatment goal before the last hospitalisation (6 versus 22 %) and were less likely to die in hospital (22 versus 49 %).
  
  
  CONCLUSIONS
  Respiratory problems were the most common reasons for hospitalisation in the group of patients as a whole. Digestive problems were a frequent reason for hospitalisation in cancer patients and cardiovascular symptoms in non-cancer patients. Hospitalisation can therefore be anticipated by monitoring these relatively common symptoms. Also, timely communication with the patient is recommended about their preferences for hospital or home treatment in the case of an acute episode.
authors.affiliation: Department of Public and Occupational Health and Expertise Center Palliative Care VUmc, VU University Medical Center (VUmc), EMGO Institute for Health and Care Research, Amsterdam, The Netherlands, eol@vumc.nl.
authors.forename: Maria C
authors.initials: MC
authors.lastname: De Korte-Verhoef
authors.forename: H Roeline W
authors.initials: HR
authors.lastname: Pasman
authors.forename: Bart P M
authors.initials: BP
authors.lastname: Schweitzer
authors.forename: Anneke L
authors.initials: AL
authors.lastname: Francke
authors.forename: Bregje D
authors.initials: BD
authors.lastname: Onwuteaka-Philipsen
authors.forename: Luc
authors.initials: L
authors.lastname: Deliens
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D009426:Netherlands / Q000453:epidemiology; D010166:Palliative Care; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013727:Terminal Care