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Hospice Care Access: a national cohort study
Everlien de Graaf1, Frederieke van der Baan1, Matthew Paul Grant2
1Center of Expertise in Palliative Care, Department of General Practice, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, The Netherlands.
BMJ Supportive & Palliative Care
|October 28, 2022
Summary
Dutch hospice care primarily serves cancer patients with diverse needs across different facility types. Future policies should aim to increase access for non-malignant disease patients and those from non-Dutch backgrounds.
Area of Science:
- Palliative Care Research
- Healthcare Access and Equity
- End-of-Life Care Studies
Background:
- Hospice care in the Netherlands is delivered through three distinct models: volunteer-driven hospices (VDH), stand-alone hospices (SAHs), and hospice units in nursing homes (HU).
- Organizational structures vary, from volunteer-led care in VDH to multiprofessional teams in SAH and HU.
Purpose of the Study:
- To characterize the patient populations accessing Dutch hospices.
- To describe patient profiles within different types of Dutch hospice facilities.
Main Methods:
- Retrospective cohort study design.
- Utilized clinical records from a random national sample of 51 Dutch hospices.
- Included 803 adult hospice inpatients from 2017-2018.
Main Results:
- The study population (n=803) had a mean age of 76.1 years, with 78% diagnosed with cancer.
- Patients presented with physical needs (100%), and varying levels of psychological (34-37%), social (52-62%), and existential needs (18-30%).
- A significant proportion required care across multiple dimensions: 24-29% in three dimensions and 3-6% in all four.
Conclusions:
- Dutch hospice patients are predominantly those with cancer, exhibiting a spectrum of physical, psychological, social, and existential needs.
- There were no substantial differences in patient profiles across VDH, SAH, and HU types.
- Patients with non-malignant diseases and non-Dutch cultural backgrounds are underrepresented, highlighting a need for policy to improve their access to hospice care.
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