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Large differences in the organization of palliative care in nursing homes in six European countries: findings from the PACE cross-sectional study

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Large differences in the organization of palliative care in nursing homes in six European countries : findings from the PACE cross-sectional study. / PACE consortium.

In: BMC Palliative Care, Vol. 20, No. 1, 131, 25.08.2021.

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@article{47a449c2666e4593bd6c284d2341e981,
title = "Large differences in the organization of palliative care in nursing homes in six European countries: findings from the PACE cross-sectional study",
abstract = "Background: To be able to provide high-quality palliative care, there need to be a number of organizational structures available in the nursing homes. It is unclear to what extent such structures are actually present in nursing homes in Europe. We aim to examine structural indicators for quality of palliative care in nursing homes in Europe and to evaluate the differences in terms of availability of and access to palliative care, infrastructure for residents and families, multidisciplinary meetings and quality improvement initiatives. Methods: A PACE cross-sectional study (2015) of nursing homes in Belgium, England, Finland, Italy, the Netherlands and Poland. Nursing homes (N = 322) were selected in each country via proportional stratified random sampling. Nursing home administrators (N = 305) filled in structured questionnaires on nursing home characteristics. Organization of palliative care was measured using 13 of the previously defined IMPACT structural indicators for quality of palliative care covering four domains: availability of and access to palliative care, infrastructure for residents and families, multidisciplinary meetings and quality improvement initiatives. We calculated structural indicator scores for each country and computed differences in indicator scores between the six countries. Pearson{\textquoteright}s Chi-square test was used to compute the p-value of each difference. Results: The availability of specialist palliative care teams in nursing homes was limited (6.1–48.7%). In Finland, Poland and Italy, specialist advice was also less often available (35.6–46.9%). Up to 49% of the nursing homes did not provide a dedicated contact person who maintained regular contact with the resident and relatives. The 24/7 availability of opioids for all nursing home residents was low in Poland (37.5%). Conclusions: This study found a large heterogeneity between countries in the organization of palliative care in nursing homes, although a common challenge is ensuring sufficient structural access to specialist palliative care services. Policymakers and health and palliative care organizations can use these structural indicators to identify areas for improvement in the organization of palliative care. ",
keywords = "Europe, Nursing home, Organization, PACE, Palliative care, Structural indicators",
author = "{PACE consortium} and E. Honinx and {Van den Block}, L. and R. Piers and B.D. Onwuteaka-Philipsen and S. Payne and K. Szczerbi{\'n}ska and G. Gambassi and M. Kyl{\"a}nen and L. Deliens and T. Smets and Y. Gatsolaeva and R. Miranda and L. Pivodic and M. Tanghe and {van Hout}, H. and R.H.R.W. Pasman and M. Oosterveld-Vlug and A.B. Wichmann and Y. Engels and M. Vernooij-Dassen and J. Hockley and S. Lepp{\"a}aho and I. Bara{\'n}ska and S. Pautex and C. Bassal and F. Mammarella and M. Mercuri and P. Rossi and I. Segat and A. Stodolska and E. Adang and P. Andreasen and O. Kuitunen-Kaija and D.C. Moore and A. Pac and V. Kijowska and {ten Koppel}, M. and {van der Steen}, J.T. and {de Paula}, E.M.",
year = "2021",
month = aug,
day = "25",
doi = "10.1186/s12904-021-00827-x",
language = "English",
volume = "20",
journal = "BMC Palliative Care",
issn = "1472-684X",
publisher = "BioMed Central Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - Large differences in the organization of palliative care in nursing homes in six European countries

T2 - findings from the PACE cross-sectional study

AU - PACE consortium

AU - Honinx, E.

AU - Van den Block, L.

AU - Piers, R.

AU - Onwuteaka-Philipsen, B.D.

AU - Payne, S.

AU - Szczerbińska, K.

AU - Gambassi, G.

AU - Kylänen, M.

AU - Deliens, L.

AU - Smets, T.

AU - Gatsolaeva, Y.

AU - Miranda, R.

AU - Pivodic, L.

AU - Tanghe, M.

AU - van Hout, H.

AU - Pasman, R.H.R.W.

AU - Oosterveld-Vlug, M.

AU - Wichmann, A.B.

AU - Engels, Y.

AU - Vernooij-Dassen, M.

AU - Hockley, J.

AU - Leppäaho, S.

AU - Barańska, I.

AU - Pautex, S.

AU - Bassal, C.

AU - Mammarella, F.

AU - Mercuri, M.

AU - Rossi, P.

AU - Segat, I.

AU - Stodolska, A.

AU - Adang, E.

AU - Andreasen, P.

AU - Kuitunen-Kaija, O.

AU - Moore, D.C.

AU - Pac, A.

AU - Kijowska, V.

AU - ten Koppel, M.

AU - van der Steen, J.T.

AU - de Paula, E.M.

PY - 2021/8/25

Y1 - 2021/8/25

N2 - Background: To be able to provide high-quality palliative care, there need to be a number of organizational structures available in the nursing homes. It is unclear to what extent such structures are actually present in nursing homes in Europe. We aim to examine structural indicators for quality of palliative care in nursing homes in Europe and to evaluate the differences in terms of availability of and access to palliative care, infrastructure for residents and families, multidisciplinary meetings and quality improvement initiatives. Methods: A PACE cross-sectional study (2015) of nursing homes in Belgium, England, Finland, Italy, the Netherlands and Poland. Nursing homes (N = 322) were selected in each country via proportional stratified random sampling. Nursing home administrators (N = 305) filled in structured questionnaires on nursing home characteristics. Organization of palliative care was measured using 13 of the previously defined IMPACT structural indicators for quality of palliative care covering four domains: availability of and access to palliative care, infrastructure for residents and families, multidisciplinary meetings and quality improvement initiatives. We calculated structural indicator scores for each country and computed differences in indicator scores between the six countries. Pearson’s Chi-square test was used to compute the p-value of each difference. Results: The availability of specialist palliative care teams in nursing homes was limited (6.1–48.7%). In Finland, Poland and Italy, specialist advice was also less often available (35.6–46.9%). Up to 49% of the nursing homes did not provide a dedicated contact person who maintained regular contact with the resident and relatives. The 24/7 availability of opioids for all nursing home residents was low in Poland (37.5%). Conclusions: This study found a large heterogeneity between countries in the organization of palliative care in nursing homes, although a common challenge is ensuring sufficient structural access to specialist palliative care services. Policymakers and health and palliative care organizations can use these structural indicators to identify areas for improvement in the organization of palliative care.

AB - Background: To be able to provide high-quality palliative care, there need to be a number of organizational structures available in the nursing homes. It is unclear to what extent such structures are actually present in nursing homes in Europe. We aim to examine structural indicators for quality of palliative care in nursing homes in Europe and to evaluate the differences in terms of availability of and access to palliative care, infrastructure for residents and families, multidisciplinary meetings and quality improvement initiatives. Methods: A PACE cross-sectional study (2015) of nursing homes in Belgium, England, Finland, Italy, the Netherlands and Poland. Nursing homes (N = 322) were selected in each country via proportional stratified random sampling. Nursing home administrators (N = 305) filled in structured questionnaires on nursing home characteristics. Organization of palliative care was measured using 13 of the previously defined IMPACT structural indicators for quality of palliative care covering four domains: availability of and access to palliative care, infrastructure for residents and families, multidisciplinary meetings and quality improvement initiatives. We calculated structural indicator scores for each country and computed differences in indicator scores between the six countries. Pearson’s Chi-square test was used to compute the p-value of each difference. Results: The availability of specialist palliative care teams in nursing homes was limited (6.1–48.7%). In Finland, Poland and Italy, specialist advice was also less often available (35.6–46.9%). Up to 49% of the nursing homes did not provide a dedicated contact person who maintained regular contact with the resident and relatives. The 24/7 availability of opioids for all nursing home residents was low in Poland (37.5%). Conclusions: This study found a large heterogeneity between countries in the organization of palliative care in nursing homes, although a common challenge is ensuring sufficient structural access to specialist palliative care services. Policymakers and health and palliative care organizations can use these structural indicators to identify areas for improvement in the organization of palliative care.

KW - Europe

KW - Nursing home

KW - Organization

KW - PACE

KW - Palliative care

KW - Structural indicators

U2 - 10.1186/s12904-021-00827-x

DO - 10.1186/s12904-021-00827-x

M3 - Journal article

VL - 20

JO - BMC Palliative Care

JF - BMC Palliative Care

SN - 1472-684X

IS - 1

M1 - 131

ER -