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A Prospective Survey of Patient Drop-outs in a Palliative Care Setting
Kumudam Unni1, Divakaran Edasseri
1Training and Research Department, Pain and Palliative Care Society, Old District Hospital, Trichur, Kerala, India.
Aim:
A prospective survey of patient drop-outs was carried out in a palliative care setting to understand the background of patients in the drop-out category. This was to understand the background of patients who drop out and why they drop out.
Materials And Methods:
The survey was conducted on 425 patients who had registered in the clinic in 2009 and subsequently persistently dropped out. Patients were classified on the basis of age, gender, education, disease, socioeconomic class, distance from clinic to home, family size, general health on the basis of symptoms on first arrival, reasons subsequently found for missing the appointment, primary caregiver details, and social support. The data were collected, and analyzed statistically using chi-square tests and percentages.
Results:
Majority of patients presented in the 41- to 60-year age group had secondary level education, with a family size of four. The drop-out rate was 25.06%. There was a significant association (P = 0.026) between reasons for dropping out and social support. A P-value < 0.05 shows that these are two related attributes. Yule's coefficient of association shows a negative correlation. When social support increases, the drop-out rate decreases. Majority of patients discontinued because a similar facility became available nearer their residence.
Conclusion:
A number of palliative care clinics have been created in the district and this has resulted in the significant drop-out rate.
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