title: Insights into hospitalisation of advanced cancer patients: a study of medical records.
abstract: The aim of this study was to explore reasons for the hospitalisation and place of death outcomes of terminal cancer patients. The methodology involved a qualitative content analysis of medical records pertaining to the last 3 months of life of 39 patients with one of four malignancies: prostate, breast, lung, or haematological. The results presentation is organised around three themes: decision hierarchy in health care, meanings of 'home', and late recognition of dying. Based on the detailed findings, this paper suggests that important insights into the broader goals of advanced cancer patients are offered by allied health staff, and that more effective use of the multidisciplinary team may support endeavours to achieve more home deaths for cancer patients who want this outcome. The analysis also provides new insights into the meaning of 'home' in interactions between advanced cancer patients and health professionals. The wish for 'home' appears bound up with other patient goals and the implications of this are discussed.
authors.affiliation: Centre for Palliative Care, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Adam
authors.initials: A
authors.lastname: Bostanci
authors.affiliation: Department of Public Health, La Trobe University, Melbourne, Victoria, Australia.
authors.forename: Dell
authors.initials: D
authors.lastname: Horey
authors.affiliation: McCulloch House, Supportive and Palliative Care Unit, Monash Health, Melbourne, Victoria, Australia.
authors.forename: Kate
authors.initials: K
authors.lastname: Jackson
authors.affiliation: McCulloch House, Supportive and Palliative Care Unit, Monash Health, Melbourne, Victoria, Australia.
authors.forename: Leeroy
authors.initials: L
authors.lastname: William
authors.affiliation: Palliative Care, Barwon Health, Geelong, Victoria, Australia.
authors.forename: Lise
authors.initials: L
authors.lastname: Pittmann
authors.affiliation: McCulloch House, Supportive and Palliative Care Unit, Monash Health, Melbourne, Victoria, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ward
authors.affiliation: Centre for Palliative Care, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
authors.forename: Gaye
authors.initials: G
authors.lastname: Moore
authors.affiliation: Palliative Care, Barwon Health, Geelong, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Martin
authors.affiliation: Centre for Palliative Care, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Hudson
authors.affiliation: Centre for Palliative Care, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Philip
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001293:Attitude to Death; D003657:Decision Making; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D057240:Patient Preference; D036301:Qualitative Research; D013727:Terminal Care / Q000458:organization & administration*; D014739:Victoria
keywords: cancer; multidisciplinary care team; place of death; qualitative research