title: Clinical characteristics of patients having single versus multiple patient encounters within a palliative care programme.
abstract: OBJECTIVE
  The objective of this study was to describe the clinical characteristics of patient initial presentations, and to explore associations between patients' clinical characteristics at initial presentation and number of encounters (single vs multiple) to an integrated palliative care programme.
  
  
  METHODS
  This was a retrospective study of a decedent cohort of 2922 patient initial presentations to the Edmonton Zone Palliative Care Program (EZPCP). Data included age, gender, setting of encounter, diagnosis, Edmonton Symptom Assessment System, CAGE, Mini-Mental Status Examination, Palliative Performance Status, Edmonton Classification System for Cancer Pain and time to death.
  
  
  RESULTS
  On initial presentation to the EZPCP, the mean age was 73 (SD 14 years), with 1358 (46%) being female, and the majority having a cancer diagnosis (n=2376, 81%), the most common of which was gastrointestinal primary (n=681, 29%). In univariate analyses, patients with younger age (<60), higher palliative performance status (>40%), a malignant diagnosis, gastrointestinal primary or unimpaired cognition at initial presentation were significantly associated with multiple encounters with an integrated palliative care programme (p<0.05). In a multivariate regression analysis, a malignant diagnosis, longer survival, higher performance status and initial entry through acute care sites were independently associated with multiple encounters in the programme (p<0.001).
  
  
  CONCLUSIONS
  Larger prospective studies are warranted to further elucidate the complex relationships between patient clinical characteristics, initial presentations and subsequent encounters to an integrated palliative care programme.
authors: Department of Symptom Control and Palliative Care, Cross Cancer Institute, Edmonton, Alberta, Canada.
authors: Sonya S
authors: SS
authors: Lowe
authors: Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
authors: Cheryl
authors: C
authors: Nekolaichuk
authors: Division of Experimental Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
authors: Sunita
authors: S
authors: Ghosh
authors: Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
authors: Lara
authors: L
authors: Fainsinger
authors: Edmonton Zone Palliative Care Program, Alberta Health Services, Edmonton, Alberta, Canada.
authors: Hue
authors: H
authors: Quan
authors: Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
authors: Robin
authors: R
authors: Fainsinger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072716:Cancer Pain / Q000628:therapy*; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000706:statistics & numerical data*; D015397:Program Evaluation / Q000706:statistics & numerical data*; D012189:Retrospective Studies
keywords: palliative care; questionnaires; referral and consultation; risk factors