Scaccabarozzi Gianlorenzo, Crippa Matteo, Amodio Emanuele, Pellegrini Giacomo
Dipartimento Fragilità-Rete Locale Cure Palliative, ASST di Lecco, 23807 Merate, Italy.
Fondazione Floriani, Via Privata Nino Bonnet, 2, 20154 Milano, Italy.
Healthcare (Basel). 2022 Feb 11;10(2):359. doi: 10.3390/healthcare10020359.
The sustainability of palliative care services is nowadays crucial inasmuch as resources for palliative care are internationally scarce, the funding environment is competitive, and the potential population is growing.
The DEMETRA study is a multicentre prospective observational study, describing the intensity of care and the related costs of palliative home care pathways.
475 patients were enrolled as recipients of specialized palliative home care. The majority of recipients were cancer patients (89.4%). The mean duration of palliative care pathways was 46.6 days and mean home care intensity coefficient equal to 0.6. The average daily cost of the model with the reference variables is 96.26 euros. Factors statistically significantly associated with an increase in mean daily costs were greater dependence and extreme frailty ( < 0.05). Otherwise, a longer duration of treatment course was associated with a significant decrease in mean daily costs ( < 0.001).
In terms of clinical and organizational management, considering the close association with the intensity and cost of the path, frailty should be systematically assessed by all facilities that potentially refer patients to home palliative care teams, and it should be carefully recorded in a standardized payment rate perspective.
鉴于姑息治疗资源在国际上稀缺、资金环境竞争激烈且潜在人群不断增加，如今姑息治疗服务的可持续性至关重要。
DEMETRA研究是一项多中心前瞻性观察性研究，描述了姑息家庭护理路径的护理强度及相关成本。
475名患者被纳入接受专科姑息家庭护理。大多数接受者为癌症患者（89.4%）。姑息治疗路径的平均持续时间为46.6天，平均家庭护理强度系数为0.6。具有参考变量的模型的平均每日成本为96.26欧元。与平均每日成本增加在统计学上显著相关的因素是更大的依赖性和极度虚弱（<0.05）。否则，治疗疗程较长与平均每日成本显著降低相关（<0.001）。
在临床和组织管理方面，考虑到与路径强度和成本的密切关联，所有可能将患者转介至家庭姑息治疗团队的机构都应系统评估虚弱程度，并应从标准化支付率角度仔细记录。
