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Cited by 74Palliative Care and End-of-Life IssuesHospital Admissions and OutcomesPalliative and Oncologic Care

Transitions between health care settings in the final three months of life in four EU countries

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Van den Block, Lieve, Pivodic, Lara, Pardon, Koen, Donker, Gé, Miccinesi, Guido, Moreels, Sarah, Vega Alonso, Tomas, Deliens, Luc +1 more·2015·The European Journal of Public Health
DOI 10.1093/eurpub/ckv039
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Abstract

BACKGROUND: Transitions between care settings may be related to poor quality in end-of-life care. Yet there is a lack of cross-national population-based data on transitions at the end of life. METHOD: International mortality follow-back study with data collection in Belgium, Netherlands, Italy and Spain (2009-11) via existing representative epidemiological surveillance networks of general practitioners (GPs). All general practitioners reported weekly, on a standardized registration form, every deceased patient (≥18 years) in their practice and identified those who died 'non-suddenly'. RESULTS: Among 4791 non-sudden deaths in Belgium, Netherlands, Italy and Spain, 59%, 55%, 60% and 58%, respectively, were transferred between care settings at least once in the final 3 months of life (10%, 8%, 10% and 13% in final 3 days of life); 10%, 5%, 8% and 12% were transferred three times or more (P < 0.001 in multivariate analyses adjusting for country differences in age, sex, cause of death, presence of dementia). In all countries, transitions were more frequent among patients residing at home (61-73%) than among patients residing in a care home (33-40%). Three months before death 5-7% of patients were in hospital, and this rose to 27-39% on the day of death. Patient wishes were cited as the reason for the last transition before death in 27%, 39%, 9% and 6% of cases in Belgium, Netherlands, Italy and Spain, respectively (P < 0.001). CONCLUSION: End-of-life transitions between health care settings are common across EU countries, in particular late hospitalizations for people residing at home. Frequency, type and reasons for terminal hospitalizations vary between countries.

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  • Patients receiving palliative care frequently experience multiple transitions between hospital and home.

    “Patients receiving palliative care frequently experience multiple transitions between hospital and home [15, 16].”

    From Experiences of family caregivers of patients with end-of-life cancer during the transition from hospital to home palliative care: a qualitative study (2024) · cites this paper as [16]

    The ‘Transitions between health care settings’ section reports that 55–60% of patients who died non-suddenly moved between care settings at least once in their final three months, and ‘Final transitions to place of death’ identifies home-to-hospital as the most common final transition. But the study does not establish that patients receiving palliative care frequently made multiple moves between hospital and home: it did not define its population by receipt of palliative care, and only 5–12% had three or more transitions of any kind. (LLM, conf=0.88)

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Research works printed but not linked: 38

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Cited by

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Authors
Van den Block, L., Pivodic, L., Pardon, K., Donker, G., Miccinesi, G., Moreels, S., Vega Alonso, T., Deliens, L., & Onwuteaka-Philipsen, B.
Affiliations
  • Vrije Universiteit Brussel (BE)
  • Netherlands Institute for Health Services Research (NL)
  • Istituto per lo Studio e la Prevenzione Oncologica (IT)
  • Institut Scientifique de Santé Publique (BE)
  • Amsterdam Public Health (NL)
ORCID
Venue
The European Journal of Public Health
Publisher
Oxford University Press (OUP)
Published
2015-03-30
Volume
25
Issue
4
Pages
569-575
ISSN
  • 1101-1262 (ISSN-L)
  • 1464-360X
DOI
10.1093/eurpub/ckv039
OpenAlex
W2047469502
Cited by
74
References
0
Citations by year
2026: 3 · 2025: 4 · 2024: 6 · 2023: 5 · 2022: 11 · 2021: 11 · 2020: 7 · 2019: 6 · 2018: 7 · 2017: 8 · 2016: 4 · 2015: 2
FWCI
7.50
Type
journal article
Language
en
Open access
Locations
  • European Journal of Public Health (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion)
  • VUBIR (Vrije Universiteit Brussel) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
  • European Commission (2007–2013, FP7 2007-2013, FP7/2007, 264697)
  • Fonds Wetenschappelijk Onderzoek
  • Vlaamse regering
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
end-of-life care, terminal hospitalization, last days of life, care homes, patient wishes, cross-national comparison, Belgium, Netherlands, Italy, Spain
MeSH terms
Transitional Care, Adolescent, Adult, Aged, Aged, 80 and over, Cause of Death, Dementia, Europe, Female, Hospices, Hospitalization, Humans, Male, Middle Aged, Retrospective Studies, Terminal Care, Young Adult

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