Characteristics, Outcomes and Factors for Place of Death in Patients Admitted to Community-Based Palliative Care Services in Shanghai China: A Multicenter Retrospective Cohort Study
Background: Community-based palliative care (CBPC) is only available in large cities in mainland China and little is known about who utilizes it. Objectives: This study examined the characteristics, outcomes, and factors associated with place of death (PoD) among inpatient CBPC patients. Design: Thi...
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Mary Ann Liebert
2024-10-01
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| Series: | Palliative Medicine Reports |
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| Online Access: | https://www.liebertpub.com/doi/10.1089/pmr.2024.0033 |
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| author | Yanxia Lin Chuchu Yan Dongliang Yang Murong Zhang Haiying Gao Anqi Xie Jinwen Chang Yiwen Mao Yongxing Shi |
| author_facet | Yanxia Lin Chuchu Yan Dongliang Yang Murong Zhang Haiying Gao Anqi Xie Jinwen Chang Yiwen Mao Yongxing Shi |
| author_sort | Yanxia Lin |
| collection | DOAJ |
| description | Background: Community-based palliative care (CBPC) is only available in large cities in mainland China and little is known about who utilizes it. Objectives: This study examined the characteristics, outcomes, and factors associated with place of death (PoD) among inpatient CBPC patients. Design: This was a multicenter retrospective cohort study. Settings/Subjects: All patients admitted to the inpatient CBPC unit in four community health centers in 2021 in Shanghai, China, were included. Methods: Characteristics and outcome data were extracted from electronic health records and paper version notes between September 4 and December 29, 2022. PoD was followed up on May 12, 2023. Data were analyzed using descriptive analysis and categorized using two-step clustering. Decision tree analysis was used to identify factors associated with PoD. Results: The cohort admitted in 2021 included 290 participants (Age: 75.7 ± 12.7 years; Male: n = 155, 53.4%) including two children, with a mortality rate of 59.0% and a median length of stay (LoS) of 14 days upon December 29, 2022. The primary diagnosis for 80.3% of participants was tumor. Two clusters were identified. Cluster 1 was smaller than Cluster 2 (n = 45, 15.5% vs. n = 245, 84.5%) and dominated by noncancer participants (n = 37, 82.2%), whereas Cluster 2 included 91.8% (n = 225) tumor patients. Greatest significant differences in age, sex, marital status, education level, awareness of diagnosis and/or prognosis, mortality, LoS, and costs were found between the clusters. In total, 265 deaths derived from the cohort upon May 12, 2023, occur in inpatient CBPC units (75.5%), at home (18.9%), and in hospital wards (5.7%), influenced largely by participants’ marital status and age. Conclusions: Establishing contextualized inpatient CBPC services in more places nationwide that are tailored to different characteristics between cancer patients (i.e., younger and shorter inpatient stay) and noncancer patients (i.e., older and longer stay) is essential to maintain that more dying patients remain in their community. |
| format | Article |
| id | doaj-art-0b721c0f8b3141f1ab3fd8cf8a7bbd08 |
| institution | OA Journals |
| issn | 2689-2820 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Palliative Medicine Reports |
| spelling | doaj-art-0b721c0f8b3141f1ab3fd8cf8a7bbd082025-08-20T02:31:48ZengMary Ann LiebertPalliative Medicine Reports2689-28202024-10-015148149110.1089/pmr.2024.0033Characteristics, Outcomes and Factors for Place of Death in Patients Admitted to Community-Based Palliative Care Services in Shanghai China: A Multicenter Retrospective Cohort StudyYanxia Lin0Chuchu Yan1Dongliang Yang2Murong Zhang3Haiying Gao4Anqi Xie5Jinwen Chang6Yiwen Mao7Yongxing Shi8School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China.School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China.Public Curriculum Teaching Department, Cangzhou Medical College, Cangzhou, China.Hospice Care Unit, Yingyuan Hospital, Shanghai, China.Hospice Care Unit, Jinshanwei Community Health Service Center, Shanghai, China.Hospice Care Unit, Zhongshan Community Health Service Center, Shanghai, China.Hospice Care Unit, Linfen Community Health Service Center, Shanghai, China.Hospice Care Unit, Changzheng Community Health Service Center, Shanghai, China.Shanghai Hospice Care Management Center, Shanghai, China.Background: Community-based palliative care (CBPC) is only available in large cities in mainland China and little is known about who utilizes it. Objectives: This study examined the characteristics, outcomes, and factors associated with place of death (PoD) among inpatient CBPC patients. Design: This was a multicenter retrospective cohort study. Settings/Subjects: All patients admitted to the inpatient CBPC unit in four community health centers in 2021 in Shanghai, China, were included. Methods: Characteristics and outcome data were extracted from electronic health records and paper version notes between September 4 and December 29, 2022. PoD was followed up on May 12, 2023. Data were analyzed using descriptive analysis and categorized using two-step clustering. Decision tree analysis was used to identify factors associated with PoD. Results: The cohort admitted in 2021 included 290 participants (Age: 75.7 ± 12.7 years; Male: n = 155, 53.4%) including two children, with a mortality rate of 59.0% and a median length of stay (LoS) of 14 days upon December 29, 2022. The primary diagnosis for 80.3% of participants was tumor. Two clusters were identified. Cluster 1 was smaller than Cluster 2 (n = 45, 15.5% vs. n = 245, 84.5%) and dominated by noncancer participants (n = 37, 82.2%), whereas Cluster 2 included 91.8% (n = 225) tumor patients. Greatest significant differences in age, sex, marital status, education level, awareness of diagnosis and/or prognosis, mortality, LoS, and costs were found between the clusters. In total, 265 deaths derived from the cohort upon May 12, 2023, occur in inpatient CBPC units (75.5%), at home (18.9%), and in hospital wards (5.7%), influenced largely by participants’ marital status and age. Conclusions: Establishing contextualized inpatient CBPC services in more places nationwide that are tailored to different characteristics between cancer patients (i.e., younger and shorter inpatient stay) and noncancer patients (i.e., older and longer stay) is essential to maintain that more dying patients remain in their community.https://www.liebertpub.com/doi/10.1089/pmr.2024.0033cohort studiescommunity health servicesdemographyend of life carehospice carepalliative care |
| spellingShingle | Yanxia Lin Chuchu Yan Dongliang Yang Murong Zhang Haiying Gao Anqi Xie Jinwen Chang Yiwen Mao Yongxing Shi Characteristics, Outcomes and Factors for Place of Death in Patients Admitted to Community-Based Palliative Care Services in Shanghai China: A Multicenter Retrospective Cohort Study Palliative Medicine Reports cohort studies community health services demography end of life care hospice care palliative care |
| title | Characteristics, Outcomes and Factors for Place of Death in Patients Admitted to Community-Based Palliative Care Services in Shanghai China: A Multicenter Retrospective Cohort Study |
| title_full | Characteristics, Outcomes and Factors for Place of Death in Patients Admitted to Community-Based Palliative Care Services in Shanghai China: A Multicenter Retrospective Cohort Study |
| title_fullStr | Characteristics, Outcomes and Factors for Place of Death in Patients Admitted to Community-Based Palliative Care Services in Shanghai China: A Multicenter Retrospective Cohort Study |
| title_full_unstemmed | Characteristics, Outcomes and Factors for Place of Death in Patients Admitted to Community-Based Palliative Care Services in Shanghai China: A Multicenter Retrospective Cohort Study |
| title_short | Characteristics, Outcomes and Factors for Place of Death in Patients Admitted to Community-Based Palliative Care Services in Shanghai China: A Multicenter Retrospective Cohort Study |
| title_sort | characteristics outcomes and factors for place of death in patients admitted to community based palliative care services in shanghai china a multicenter retrospective cohort study |
| topic | cohort studies community health services demography end of life care hospice care palliative care |
| url | https://www.liebertpub.com/doi/10.1089/pmr.2024.0033 |
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