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Describing Complexity in Palliative Home Care Through HexCom: A Cross-Sectional, Multicenter Study.

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  • 1Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain.

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Home care complexity is high for advanced disease patients, particularly in social/family needs. Cancer patients show higher complexity than dementia patients, highlighting the need for tailored support.

Keywords:
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Area of Science:

  • Palliative Care
  • Health Services Research
  • Gerontology

Background:

  • Complexity is a significant challenge in advanced disease and end-of-life care.
  • The Hexagon of Complexity (HexCom) model is being validated for healthcare settings.
  • Understanding complexity variations across patient groups is crucial for effective home care.

Purpose of the Study:

  • To utilize the HexCom instrument to delineate complexity differences among various disease groups in home care for advanced and end-of-life patients.
  • To analyze complexity across general, domain, and subdomain levels.

Main Methods:

  • A cross-sectional study involving interdisciplinary home care teams in Catalonia.
  • Utilized the HexCom instrument assessing 6 needs domains and 4 resource domains.
  • Patients were categorized into High (H), Moderate (M), and Low (L) complexity levels.

Main Results:

  • 832 patients were assessed by 43 teams; 61.4% had cancer.
  • Moderate (47.0%) and high (42.4%) complexity were prevalent.
  • Cancer patients had higher median complexity (51) than dementia patients (23).
  • The social/family domain presented the highest complexity.
  • Interpersonal resources were most utilized (80.5%).

Conclusions:

  • Home care support teams manage high-intensity workloads.
  • The social/family domain and end-of-life place planning are critical.
  • Significant variations in needs and resources exist across disease groups.
  • Relationship wellbeing is vital for end-of-life care.