Prevalence and typology of patients susceptible of palliative care deceased at home

Abstract

Background. Identification of patients susceptible to palliative care (SPC) in the community is essential for improving their clinical management. The objective is to explore the SPC population and their typology of illness, according to sex.

Methods. Cross-sectional study, performed on the population of Malaga who died at home during 2015. Association between type of patient (SCP or identified as palliative by inclusion in the integrated care process (ICP)). Age, sex and type of disease were analyzed with Chi square and t-Student’s test.

Results. Of 950 patients attended to after dying at home, 417 (43.9%) were SCP and, of them, 277 (66,4%) were included in the ICP. Males were more frequent in both populations (55.6 and 59.9%, respectively, p=0,26), with mean ages 78.6 and 76.2, respectively (p=0.01).

The most frequent diseases in SCP patients were: cancer (61.9%), dementia and Alzheimer (19.9%), chronic obstructive pulmonary disease (COPD) (6.2%) and heart failure (4.1%). People with cancer were more frequently included in the ICP (86.8%), while those with dementia and Alzheimer, COPD and Parkinson were less frequently included (20.5, 38.4 and 0.4% respectively).

By sex, men suffered more from cancer and women from dementia. Percentage of inclusion in ICP was similar for men and women, stratified by disease.

Conclusions. Almost half of the people who died at home are SCP although only two out of three are identified as such. Cancer is the most frequent SCP disease and the easiest one to identify, largely affecting men. Three out of four people with dementia died without being identified as PC, and they are mainly women.

Keywords. Prevalence. Palliative Care. Death. Cause of death. Home Care Services.