Use of inpatient palliative care among people who died in France in 2013, by demographic characteristics and medical conditions
Objectives: To describe the medical conditions, place of death, hospitalizations, and use of inpatient palliative care (SPH) in the year preceding death. Methods: Individuals covered by the general health insurance scheme who died in France in 2013 were identified in the National Inter-Regime Health Insurance Information System (Sniiram), with data selected regarding their various hospital stays, the presence of HPC, and their stay in a long-term care facility for dependent elderly individuals (Ehpad). Conditions were identified using algorithms based on healthcare utilization reported in Sniiram. Results: 347,253 individuals were included (61% of those who died in France in 2013). The average age at death was 77 years. Deaths occurred during hospitalization in 60% of cases (51% during short-term stays, 6% in follow-up care and rehabilitation, 3% in home hospitalization) and in nursing homes in 13% of cases. In the year prior to death, 84% of individuals were hospitalized at least once, and 29% received palliative care, with significant variations by age and sex. Among those with treated cancer, the use of palliative care was 52% (lung cancer 62%, prostate cancer 41%). In the absence of cancer, the use of SPH varied by condition: acute stroke (24%), heart failure (17%), multiple sclerosis (23%), and dementia (17%). Discussion Conclusion: This initial assessment needs to be refined, but it highlights the value of Sniiram data, which should help improve understanding of the care pathway leading up to death and the use of palliative care services, and enable the development of monitoring indicators to evaluate, among other things, certain initiatives that have been implemented.
Author(s): Poulalhon C, Rotelli Bihet L, Fagot Campagna A, Aubry R, Tuppin P
Publishing year: 2017
Pages: 641-50
Weekly Epidemiological Bulletin, 2017, n° 31, p. 641-50
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