<abstract xmlns="http://www.w3.org/1999/xhtml">
<sec id="j_sjph-2023-0007_s_006"><h3>Introduction</h3>
<p>Spending one’s last days and dying at home is a common wish of people with a life-limiting illness. Home-based palliative care is essentially organised at the primary level to meet the needs of palliative patients and their carers. The aim of this study was to identify the characteristics of home-based palliative care, focusing on those who identify palliative patients, what their needs are and how this affects their length of life and site of death.</p>
</sec>
<sec id="j_sjph-2023-0007_s_007"><h3>Methods</h3>
<p>This retrospective cohort study analysed routinely collected notes of patients enrolled in home-based palliative care between 2015 and 2021. Palliative care was provided by a primary health care team in a predominantly rural area.</p>
</sec>
<sec id="j_sjph-2023-0007_s_008"><h3>Results</h3>
<p>This study included 107 palliative patients, aged 71±11.4 years, 94% of whom had cancer. They were enrolled in palliative care by their primary care team or by hospital staff. The enrolment by hospital staff (3%) resulted in significantly shorter survival (p=0.008). Patients lived an average of 66 days, and 65% of patients died at home. Home-based palliative care was found to respond to both basic and complex palliative medical needs, but was weaker in addressing socio-economic, psychological or spiritual issues.</p>
</sec>
<sec id="j_sjph-2023-0007_s_009"><h3>Conclusion</h3>
<p>This exemplary primary-level palliative team provided home-based palliative care that has improved over the years in terms of all the observed quality indicators: early enrolment, the proportion of patients dying at home and the ability to address needs. Specialised mobile palliative teams, hospitals and other palliative care settings complement home-based palliative care.</p>
</sec>
</abstract>

Introduction
Spending one’s last days and dying at home is a common wish of people with a life-limiting illness. Home-based palliative care is essentially organised at the primary level to meet the needs of palliative patients and their carers. The aim of this study was to identify the characteristics of home-based palliative care, focusing on those who identify palliative patients, what their needs are and how this affects their length of life and site of death.

Methods
This retrospective cohort study analysed routinely collected notes of patients enrolled in home-based palliative care between 2015 and 2021. Palliative care was provided by a primary health care team in a predominantly rural area.

Results
This study included 107 palliative patients, aged 71±11.4 years, 94% of whom had cancer. They were enrolled in palliative care by their primary care team or by hospital staff. The enrolment by hospital staff (3%) resulted in significantly shorter survival (p=0.008). Patients lived an average of 66 days, and 65% of patients died at home. Home-based palliative care was found to respond to both basic and complex palliative medical needs, but was weaker in addressing socio-economic, psychological or spiritual issues.

Conclusion
This exemplary primary-level palliative team provided home-based palliative care that has improved over the years in terms of all the observed quality indicators: early enrolment, the proportion of patients dying at home and the ability to address needs. Specialised mobile palliative teams, hospitals and other palliative care settings complement home-based palliative care.

What palliative patients and their carers need at home and what a primary health care team can offer – first pilot study in Slovenia

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Kaj potrebujejo paliativni bolniki in njihovi oskrbovalci na domu in kaj lahko ponudi tim osnovnega zdravstva – prva Slovenska pilotna raziskava

Introduction
Spending one’s last days and dying at home is a common wish of people with a life-limiting illness. Home-based palliative care is essentially...

		N (%)	Survival (days) mean±SD	p	Died at home N (%)	p
Gender	Male	61 (57%)	65±119	0.882	33	0.484
	Female	46 (43%)	68±109		28
Age (years)	45–54	11 (10%)	45±63	0.771	4	0.296
	55–64	18 (17%)	55±124		11
	65–74	32 (30%)	76±142		16
	75–84	31 (29%)	59±85		20
	85–90	14 (13%)	91±130		10
Leading condition	Cancer	101 (94%)	63±111	0.467	57	0.623
	Non-cancer	6 (6%)	117±164		4
Enrolment by	Family doctor	48 (45%)	76±110	0.009	1	0.267
	OOH/ES	36 (34%)	53±113		32
	Community nurse	20 (19%)	72±137		17
	Hospital team	3 (3%)	21±11		11

Year	No of patients enrolled	Died at home	Did not die at home
2015	3	0 (0%)	3 (100%)
2016	17	9 (53%)	8 (47%)
2017	12	8 (67%)	4 (33%)
2018	13	9 (69%)	4 (31%)
2019	23	14 (61%)	9 (39%)
2020	16	12 (75%)	4 (25%)
2021	23	18 (78%)	5 (22%)

What palliative patients and their carers need at home and what a primary health care team can offer – first pilot study in Slovenia

Article Category: Original scientific article

Pubblicato online: 03 gen 2023

Pagine: 48 - 54

Ricevuto: 03 set 2022

Accettato: 21 nov 2022

DOI: https://doi.org/10.2478/sjph-2023-0007

Parole chiave
palliative care, home care, primary health care, needs assessment

© 2023 National Institute of Public Health, Slovenia, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Figure 3

Characteristics of palliative patients and palliative care.

Categories of palliative needs.

Enrolled patients in years and their site of death.

Category
Pain
Dyspnoea, heavy breathing, cough
Loss of appetite, dysphagia, cachexia
Nausea, vomiting
Constipation, ileus, diarrhoea
Confusion, hallucinations, delirium, restlessness
Anxiety, depression
Dying
Medical procedures
Psychological support to patients
Psychological support to carers
Socio-economic status
Spiritual support

What palliative patients and their carers need at home and what a primary health care team can offer – first pilot study in Slovenia

Article Category: Original scientific article

Pubblicato online: 03 gen 2023

Pagine: 48 - 54

Ricevuto: 03 set 2022

Accettato: 21 nov 2022

DOI: https://doi.org/10.2478/sjph-2023-0007

Parole chiavepalliative care, home care, primary health care, needs assessment

© 2023 National Institute of Public Health, Slovenia, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Figure 3

Characteristics of palliative patients and palliative care.

Categories of palliative needs.

Enrolled patients in years and their site of death.

Parole chiave
palliative care, home care, primary health care, needs assessment