[Palliative care at home: patient care pathways and clinical characteristics]

The great majority of French people express their desire to receive palliative care at home. The objective of this study was to describe the clinical care pathways and characteristics of patient receiving hospital at home palliative care.

This study compared the care pathways and clinical characteristics of patients receiving palliative care at home in the Ile-de-France region in 2014. Retrospective data were extracted from the French medical information systems programme.

817 patients receiving palliative care at home were included in the study. They were older, more often referred to hospital at home by a primary care physician, had shorter lengths of stay and more often died at home compared to patients without palliative care. Palliative care patients mainly presented cancer and received frequent technical nursing care. The oldest patients (≥ 75 years old) more often presented neurodegenerative diseases, were less often transferred to hospital, and more often died at home compared to younger patients. A higher proportion of home deaths was observed in nursing home residents and patients who died at home required less technical nursing care.

This study provides important information concerning admission to hospital at home, the frequent changes of places of care and the complexity of maintaining palliative care at home until the patient's death.