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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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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'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
Organization, Structural indicators, Palliative care, Nursing home, Europe, PACE, QUALITY INDICATORS, DEMENTIA, RESIDENTS, LIFE

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MLA
Honinx, Elisabeth, et al. “Large Differences in the Organization of Palliative Care in Nursing Homes in Six European Countries : Findings from the PACE Cross-Sectional Study.” BMC PALLIATIVE CARE, vol. 20, no. 1, 2021, doi:10.1186/s12904-021-00827-x.
APA
Honinx, E., Van den Block, L., Piers, R., Onwuteaka-Philipsen, B., Payne, S., Szczerbińska, K., … Smets, T. (2021). Large differences in the organization of palliative care in nursing homes in six European countries : findings from the PACE cross-sectional study. BMC PALLIATIVE CARE, 20(1). https://doi.org/10.1186/s12904-021-00827-x
Chicago author-date
Honinx, Elisabeth, Lieve Van den Block, Ruth Piers, BD Onwuteaka-Philipsen, S Payne, K Szczerbińska, G Gambassi, M Kylänen, Luc Deliens, and Tinne Smets. 2021. “Large Differences in the Organization of Palliative Care in Nursing Homes in Six European Countries : Findings from the PACE Cross-Sectional Study.” BMC PALLIATIVE CARE 20 (1). https://doi.org/10.1186/s12904-021-00827-x.
Chicago author-date (all authors)
Honinx, Elisabeth, Lieve Van den Block, Ruth Piers, BD Onwuteaka-Philipsen, S Payne, K Szczerbińska, G Gambassi, M Kylänen, Luc Deliens, and Tinne Smets. 2021. “Large Differences in the Organization of Palliative Care in Nursing Homes in Six European Countries : Findings from the PACE Cross-Sectional Study.” BMC PALLIATIVE CARE 20 (1). doi:10.1186/s12904-021-00827-x.
Vancouver
1.
Honinx E, Van den Block L, Piers R, Onwuteaka-Philipsen B, Payne S, Szczerbińska K, et al. Large differences in the organization of palliative care in nursing homes in six European countries : findings from the PACE cross-sectional study. BMC PALLIATIVE CARE. 2021;20(1).
IEEE
[1]
E. Honinx et al., “Large differences in the organization of palliative care in nursing homes in six European countries : findings from the PACE cross-sectional study,” BMC PALLIATIVE CARE, vol. 20, no. 1, 2021.
@article{8719877,
  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'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.}},
  articleno    = {{131}},
  author       = {{Honinx, Elisabeth and Van den Block, Lieve and Piers, Ruth and Onwuteaka-Philipsen, BD and Payne, S and Szczerbińska, K and Gambassi, G and Kylänen, M and Deliens, Luc and Smets, Tinne}},
  issn         = {{1472-684X}},
  journal      = {{BMC PALLIATIVE CARE}},
  keywords     = {{Organization,Structural indicators,Palliative care,Nursing home,Europe,PACE,QUALITY INDICATORS,DEMENTIA,RESIDENTS,LIFE}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{12}},
  title        = {{Large differences in the organization of palliative care in nursing homes in six European countries : findings from the PACE cross-sectional study}},
  url          = {{http://dx.doi.org/10.1186/s12904-021-00827-x}},
  volume       = {{20}},
  year         = {{2021}},
}

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