Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
J Pain Symptom Manage. 2011 Feb;41(2):436-48. doi: 10.1016/j.jpainsymman.2010.04.016. Epub 2010 Sep 15.
At the end of life, some personalized and specialized care is required. The way that general practitioner (GP) visits and palliative care services at the end of life are organized in different countries may impact the frequency of care provision. However, nationwide data on the prevalence of these interventions and comparisons among countries are scarce.
To compare the frequency of GP visits and use of palliative care services at the end of life in two European countries and identify the associated factors.
In 2007, two mortality follow-back studies were conducted simultaneously in The Netherlands and Belgium, using existing Sentinel GP networks and similar standardized procedures. Within the one-year period, all registered patients who died at home or in a care home were selected.
From the data of 543 registered patients, GP visits were more frequent at the end of life in The Netherlands than in Belgium: the mean number of GP visits in the last week of life was 5.1 vs. 3.2 (home) and 4.4 vs. 2.3 (care home). Conversely, palliative care services in the last three months of life were used more frequently in Belgium than in The Netherlands: 78% vs. 41% (home) and 39% vs. 5% (care homes). The differences between countries remained consistent despite correcting for possible confounders. Having more frequent GP visits at home was associated with cancer-related deaths both in The Netherlands and Belgium.
Independent of the differences in patient populations (at home and care home) between countries, there are more frequent GP visits at the end of life in The Netherlands and greater use of palliative care services in Belgium.
在生命末期，需要一些个性化和专业化的护理。不同国家对全科医生（GP）就诊和临终关怀服务的组织方式可能会影响护理提供的频率。然而，关于这些干预措施在全国范围内的流行程度以及国家间的比较数据却很少。
比较两个欧洲国家在生命末期 GP 就诊和使用姑息治疗服务的频率，并确定相关因素。
2007 年，在荷兰和比利时同时进行了两项死亡率回溯研究，利用现有的全科医生监测网络和类似的标准化程序。在一年的时间内，所有在家中或养老院死亡的登记患者都被选中。
从 543 名登记患者的数据中，荷兰的 GP 在生命末期就诊次数比比利时更为频繁：生命最后一周的 GP 就诊次数，在家中为 5.1 次，比利时为 3.2 次；在养老院中为 4.4 次，比利时为 2.3 次。相反，在生命的最后三个月中，比利时使用姑息治疗服务的频率高于荷兰：在家中为 78%，荷兰为 41%；在养老院中为 39%，荷兰为 5%。尽管对可能的混杂因素进行了校正，但国家间的差异仍然存在。在家中 GP 就诊更为频繁与荷兰和比利时的癌症相关死亡有关。
无论两国在家中和养老院患者人群（人群）的差异如何，荷兰的 GP 在生命末期就诊更为频繁，而比利时姑息治疗服务的使用率更高。
