title: Home care for brain tumor patients.
abstract: BACKGROUND
  Brain tumor patients are quite different from other populations of cancer patients due to the complexity of supportive care needs, the trajectory of disease, the very short life expectancy, and resulting need for a specific palliative approach.
  
  
  METHODS
  A pilot program of comprehensive palliative care for brain tumor patients was started in the Regina Elena National Cancer Institute of Rome in October 2000, supported by the Lazio Regional Health System. The aim of this model of assistance was to meet patient's needs for care in all stages of disease, support the families, and reduce the rehospitalization rate. The efficacy of the model of care was evaluated analyzing the place of death, caregiver satisfaction, rehospitalization rate, and the impact on costs to the health system.
  
  
  RESULTS
  From October 2000 to December 2012, 848 patients affected by brain tumor were enrolled in a comprehensive program of neuro-oncological home care. Out of 529 patients who died, 323 (61%) were assisted at home until death, 117 (22.2%) died in hospital, and 89 (16.8%) died in hospice. A cost-effectiveness analysis demonstrated a significant reduction in hospital readmission rates in the last 2 months of life compared with the control group (16.7% vs 38%;P< .001).
  
  
  CONCLUSIONS
  Our findings concerning death at home, rehospitalization rate, quality of life, and satisfaction of patients and their relatives with the care received suggest that a neuro-oncologic palliative home-care program has a positive impact on the quality of care for brain tumor patients, particularly at the end of life.
authors.affiliation: Department of Neuroscience , Regina Elena National Cancer Institute , Rome , Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pace
authors.affiliation: Department of Neuroscience , Regina Elena National Cancer Institute , Rome , Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Villani
authors.affiliation: Department of Neuroscience , Regina Elena National Cancer Institute , Rome , Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Di Pasquale
authors.affiliation: Department of Neuroscience , Regina Elena National Cancer Institute , Rome , Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Benincasa
authors.affiliation: Department of Neuroscience , Regina Elena National Cancer Institute , Rome , Italy.
authors.forename: Lara
authors.initials: L
authors.lastname: Guariglia
authors.affiliation: Department of Neuroscience , Regina Elena National Cancer Institute , Rome , Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Ieraci
authors.affiliation: Department of Neuroscience , Regina Elena National Cancer Institute , Rome , Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Focarelli
authors.affiliation: Department of Neuroscience , Regina Elena National Cancer Institute , Rome , Italy.
authors.forename: Carmine Maria
authors.initials: CM
authors.lastname: Carapella
authors.affiliation: Department of Neuroscience , Regina Elena National Cancer Institute , Rome , Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Pompili
keywords: brain tumors; end-of-life; home care; palliative care; place of death