Chumbley Karen, Wilson Tim, Ison Erica, Orlowski Andi
St Helena Hospice, Barncroft Close, Colchester, CO49JU, UK.
Oxford Centre for Triple Value Healthcare Ltd, Summertown Pavilion, Middle Way, Oxford, OX2 7LG, UK.
Res Health Serv Reg. 2023 Mar 8;2(1):5. doi: 10.1007/s43999-023-00019-5.
This study looks at the variations in end-of-life care in North-East Essex (eastern England) combining hospital records, official death records and the local electronic end-of-life coordination tool. These differences included dying in hospital (versus a general wish to die in the usual place of residence), and inequity in care provision: the place of death varying according to the cause of death (even for highly predictable conditions); and deprivation being associated with a greater likelihood of dying in hospital. There was a positive correlation between the use of an electronic end-of-life coordination system and dying in the preferred place of care. The results suggest two actions for policy makers. First, look at variations in end-of-life care so that areas of need can be identified. Second, use of an electronic end-of-life coordination tool is correlated with a reduction in unwarranted variation in the place of death.
本研究结合医院记录、官方死亡记录和当地电子临终关怀协调工具，考察了埃塞克斯东北部（英格兰东部）临终关怀的差异。这些差异包括在医院死亡（与通常希望在常住地死亡的普遍愿望相悖）以及护理提供方面的不平等：死亡地点因死因而异（即使是对于高度可预测的病症）；贫困与在医院死亡的可能性增加有关。使用电子临终关怀协调系统与在首选护理地点死亡之间存在正相关。研究结果为政策制定者提出了两项行动建议。第一，审视临终关怀的差异，以便确定需求领域。第二，使用电子临终关怀协调工具与减少死亡地点的不合理差异相关。
