Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
152971Bruyère Research Institute, Ottawa, Ontario, Canada.
J Palliat Care. 2021 Jan;36(1):46-49. doi: 10.1177/0825859720951368. Epub 2020 Aug 18.
Limited research has characterized team-based models of home palliative care and the outcomes of patients supported by these care teams.
A retrospective case series describing care and outcomes of patients managed by the London Home Palliative Care Team between May 1, 2017 and April 1, 2019.
The London Home Palliative Care (LHPC) Team care model is based upon 3 pillars: 1) physician visit availability 2) active patient-centered care with strong physician in-home presence and 3) optimal administrative organization.
In the 18 month study period, 354 patients received care from the London Home Palliative Care Team. Most significantly, 88.4% ( = 313) died in the community or at a designated palliative care unit after prearranged direct transfer; no comparable provincial data is available. 21.2% ( 75) patients visited an emergency department and 24.6% ( 87) were admitted to hospital at least once in their final 30 days of life. 280 (79.1%) died in the community. These values are better than comparable provincial estimates of 62.7%, 61.7%, and 24.0%, respectively.
The London Home Palliative Care (LHPC) Team model appears to favorably impact community death rate, ER visits and unplanned hospital admissions, as compared to accepted provincial data. Studies to determine if this model is reproducible could support palliative care teams achieving similar results.
有限的研究描述了基于团队的家庭姑息治疗模式以及这些护理团队支持的患者的结局。
一项回顾性病例系列研究，描述了 2017 年 5 月 1 日至 2019 年 4 月 1 日期间伦敦家庭姑息治疗团队管理的患者的护理和结局。
伦敦家庭姑息治疗（LHPC）团队的护理模式基于 3 个支柱：1）医生访问的可用性；2）以患者为中心的积极护理，医生在家中进行强有力的干预；3）最佳的行政组织。
在 18 个月的研究期间，354 名患者接受了伦敦家庭姑息治疗团队的治疗。最重要的是，88.4%（=313）的患者在社区或指定的姑息治疗病房去世，这些患者在预先安排的直接转院后去世；没有可比的省级数据。21.2%（75）的患者去了急诊室，24.6%（87）的患者在生命的最后 30 天至少住院一次。280 名（79.1%）患者在社区死亡。这些数值均优于可比的省级估计值，分别为 62.7%、61.7%和 24.0%。
与公认的省级数据相比，伦敦家庭姑息治疗（LHPC）团队模式似乎对社区死亡率、急诊室就诊和非计划住院有积极影响。确定该模式是否具有可复制性的研究可以支持姑息治疗团队取得类似的结果。
