title: Structure, organisation and clinical outcomes in cancer patients of hospital support teams in Spain.
abstract: OBJECTIVE
  To describe the structure, characteristics of patients and basic clinical outcomes in cancer patients receiving care from palliative care hospital support teams (HSTs) in Spain.
  
  
  METHODS
  A multi-centre observational two phase study. Phase I: A descriptive survey of all HSTs in Spain. Phase II: A quasi-experimental prospective cohort study to describe the clinical outcomes, symptom severity and survival.
  
  
  RESULTS
  60 HSTs in Spain met the inclusion criteria. All HSTs were multidisciplinary with wide experience (mean 6.8 years). HSTs coverage was 21.5% of all cancer deaths in Spain. A total number of 364 advanced cancer patients were included in the cohort study; 76% were classified as moderate or high complexity. Overall, 64% were male subjects and the most frequent primary cancer site was lung (26%). Half of the patients had no detailed information about cancer staging and only 19% knew their short-term prognosis. The mean length of intervention was 6.5 days (mean three visits per patient). Outcomes were: 34% deaths during the admission process; 38% were discharged home; and 28% were transferred to another medium-term-stay specialist unit. The main symptoms were pain (68%), dyspnoea (43%), vomiting (24%), anorexia (72%), asthenia (78%), insomnia (50%), anxiety (45%) and depression (35%). After the HSTs intervention, the symptom severity was significantly reduced (p<0.001) for all symptoms, except for weakness and anorexia. The mean survival from inclusion was 111 days.
  
  
  CONCLUSIONS
  Palliative intervention of HSTs is characterised by being adjusted to patient needs and short duration. Their care was focused on the preterminal phase of cancer patients of moderate-high complexity.
authors.affiliation: Supportive and Palliative Care Unit, Cancer and Hematologic Diseases Institute, Hospital Clínic Barcelona, Barcelona University, Barcelona, Spain.
authors.forename: Albert
authors.initials: A
authors.lastname: Tuca-Rodriguez
authors.forename: Xavier
authors.initials: X
authors.lastname: Gómez-Batiste
authors.forename: Jose
authors.initials: J
authors.lastname: Espinosa-Rojas
authors.forename: Marisa
authors.initials: M
authors.lastname: Martínez-Muñoz
authors.forename: Nuria
authors.initials: N
authors.lastname: Codorniu
authors.forename: Josep
authors.initials: J
authors.lastname: Porta-Sales
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006757:Hospital Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000379:methods* / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012720:Severity of Illness Index; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis