Nurse practitioner and physician end-of-life home visits and end-of-life outcomes

被引：0

作者：

Scott, Mary ^{[1
,14
]}

Ramzy, Amy ^{[2
]}

Isenberg, Sarina Roslyn ^{[2
,3
]}

Webber, Colleen ^{[1
]}

Eddeen, Anan Bader ^{[4
]}

Murmann, Maya ^{[2
]}

Mahdavi, Roshanak ^{[4
]}

Howard, Michelle ^{[5
]}

Kendall, Claire E. ^{[2
,6
]}

Klinger, Christopher ^{[7
]}

Marshall, Denise ^{[7
]}

Sinnarajah, Aynharan ^{[8
,9
]}

Ponka, David ^{[6
]}

Buchman, Sandy ^{[10
]}

Bennett, Carol ^{[1
]}

Tanuseputro, Peter ^{[1
,2
,3
,4
]}

Dahrouge, Simone ^{[2
,6
]}

May, Kathryn ^{[11
]}

Heer, Carrie ^{[2
,12
]}

Cooper, Dana ^{[13
]}

Manuel, Douglas ^{[1
,2
,4
,6
]}

Thavorn, Kednapa ^{[1
,4
]}

Hsu, Amy T. ^{[2
,6
,15
]}

机构：

[1] Ottawa Hosp Res Inst, Clin Epidemiol Program, Ottawa, ON, Canada

[2] Bruyere Res Inst, Ottawa, ON, Canada

[3] Univ Ottawa, Dept Med, Div Palliat Care, Ottawa, ON, Canada

[4] Inst Clin Evaluat Sci, ICES uOttawa, Toronto, ON, Canada

[5] McMaster Univ, Dept Family Med, Hamilton, ON, Canada

[6] Univ Ottawa, Dept Family Med, Ottawa, ON, Canada

[7] McMaster Univ, Dept Family Med, Div Palliat Care, Hamilton, ON, Canada

[8] Queens Univ, Dept Med, Div Palliat Med, Kingston, ON, Canada

[9] Lakeridge Hlth, Oshawa, ON, Canada

[10] Univ Toronto, Dept Family & Community Med, Div Palliat Care, Toronto, ON, Canada

[11] Ottawa Hosp, Dept Emergency Med, Ottawa, ON, Canada

[12] Univ Toronto, Lawrence Bloomberg Fac Nursing, Toronto, ON, Canada

[13] Nurse PractitionersAssociat, Toronto, ON, Canada

[14] Ottawa Hosp Res Inst, Ottawa, ON, Canada

[15] Bruyere Res Inst, Ottawa, ON, Canada

来源：

BMJ SUPPORTIVE & PALLIATIVE CARE | 2023年

关键词：

Home Care; Hospital care; Pain; End of life care; PRIMARY-CARE; ONTARIO;

D O I：

10.1136/spcare-2023-004392

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

ObjectivesPhysicians and nurse practitioners (NPs) play critical roles in supporting palliative and end-of-life care in the community. We examined healthcare outcomes among patients who received home visits from physicians and NPs in the 90 days before death.MethodsWe conducted a retrospective cohort study using linked data of adult home care users in Ontario, Canada, who died between 1 January 2018 and 31 December 2019. Healthcare outcomes included medications for pain and symptom management, emergency department (ED) visits, hospitalisations and a community-based death. We compared the characteristics of and outcomes in decedents who received a home visit from an NP, physician and both to those who did not receive a home visit.ResultsHalf (56.9%) of adult decedents in Ontario did not receive a home visit from a provider in the last 90 days of life; 34.5% received at least one visit from a physician, 3.8% from an NP and 4.9% from both. Compared with those without any visits, having at least one home visit reduced the odds of hospitalisation and ED visits, and increased the odds of receiving medications for pain and symptom management and achieving a community-based death. Observed effects were larger in patients who received at least one visit from both.ConclusionsBeyond home care, receiving home visits from primary care providers near the end of life may be associated with better outcomes that are aligned with patients' preferences-emphasising the importance of NPs and physicians' role in supporting people near the end of life.

引用

页数：9

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