多学科团队和病房转诊至医院姑息治疗科的晚期癌症患者所评估的复杂程度差异：一项回顾性研究。

Difference in the level of complexity assessed on patients with advanced cancer referred to a hospital-based palliative care unit by multidisciplinary teams and wards: a retrospective study.

作者信息

Tanzi Silvia, Peruselli Carlo, Alquati Sara, Pellegri Carlotta, Sacchi Simona

机构信息

Palliative Care Unit, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy.

Former President SICP, Italian Society of Palliative Care, Biella, Italy.

出版信息

BMC Health Serv Res. 2025 Jul 1;25(1):842. doi: 10.1186/s12913-025-12940-1.

DOI:10.1186/s12913-025-12940-1

PMID:40598259

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12210531/

Abstract

BACKGROUND

The main criterion for the intervention of specialist palliative care is how to balance complexity of needs and prognosis. Appropriate organization and dedicated clinical tools should enable the clinicians and patients to meet this criterion.

METHODS

We conducted a retrospective observational study on 184 cancer patients referred to a specialized palliative care service. The difference in level of complexity was analyzed using the PALCOM scale assessment tool in regard to referrals from multidisciplinary teams versus wards. A specialized palliative care service trained the health professionals of the multidisciplinary teams in 2019 and has been working daily in the hospital since 2013.

RESULTS

The number of referrals to the palliative care service by the wards was more than double the referrals by the multidisciplinary teams, and the level of complexity was 45% for patients referred by wards vs. 10% referred by discussion teams. From our results, it seems reasonable to assume that training in complexity tools may increase the number of referrals to the palliative care service, while working alongside the health professionals in the wards leads to an increase in recognizing complex needs and thus better appropriateness of referrals to the palliative care service.

CONCLUSIONS

A hospital-based specialist palliative care service with clinical and training expertise can increase the appropriateness of referrals.

摘要

背景

专科姑息治疗干预的主要标准是如何平衡需求的复杂性和预后。适当的组织和专门的临床工具应使临床医生和患者能够满足这一标准。

方法

我们对184名转诊至专科姑息治疗服务机构的癌症患者进行了一项回顾性观察研究。使用PALCOM量表评估工具分析了多学科团队与病房转诊患者的复杂性水平差异。一家专科姑息治疗服务机构在2019年对多学科团队的卫生专业人员进行了培训，自2013年以来一直在该医院开展日常工作。

结果

病房转诊至姑息治疗服务机构的患者数量是多学科团队转诊患者数量的两倍多，病房转诊患者的复杂性水平为45%，而讨论团队转诊患者的复杂性水平为10%。从我们的结果来看，合理的假设是，对复杂性工具的培训可能会增加转诊至姑息治疗服务机构的患者数量，同时与病房的卫生专业人员合作会增加对复杂需求的认识，从而使转诊至姑息治疗服务机构更加合适。