End of Life Care, Palliative Care, Terminal Care
Conditions
Keywords
Palliative Care, End of Life Care, Primary Health Care, General Practitioners, Care Coordination, Place of Death, Advance Directives, Health Services Utilization, Retrospective Studies
Brief summary
This retrospective descriptive study aims to describe the sociodemographic, clinical, and organizational characteristics of patients identified as receiving palliative care who died in 2024 within the NOVO Hospital network. Data from medical records will include patient characteristics, involvement of general practitioners, use of palliative care services, healthcare utilization, and conditions of death. The study hypothesizes that improved characterization of these patients and their care trajectories will help identify opportunities for earlier palliative care referral and better coordination between hospital and community care.
Detailed description
Population aging and the increasing prevalence of chronic diseases and frailty have led to a growing demand for palliative care. End-of-life trajectories are frequently complex and involve multiple transitions between hospital care, home, and long-term care facilities. In many healthcare systems, a large proportion of healthcare expenditures in the last months of life is related to hospitalizations. A better understanding of the characteristics and care pathways of patients receiving palliative care is therefore essential to improve the organization and coordination of end-of-life care. In France, general practitioners play a key role in the follow-up of patients and in coordinating care between hospital and community settings. However, the identification of palliative care needs and the timing of referral to specialized palliative care services remain heterogeneous. Improved knowledge of patient profiles and care trajectories may help identify opportunities to strengthen collaboration between hospital teams and primary care physicians. This retrospective monocentric descriptive study will analyze patients identified as receiving palliative care who died in 2024 within the NOVO Hospital network. Data will be extracted from the medical record system and anonymized prior to analysis. Collected variables will include sociodemographic characteristics, clinical information such as comorbidities, level of autonomy, and data related to the organization of care. Particular attention will be given to the involvement of general practitioners, the use of specialized palliative care teams, and access to home-based care services. The study will also examine healthcare utilization in the last months of life, including hospital admissions and emergency department visits, as well as end-of-life conditions such as the place of death, the presence of advance directives, and the use of continuous deep sedation. By describing patient profiles and care trajectories, this study aims to identify potential factors associated with healthcare utilization and to highlight opportunities to improve early palliative care identification and coordination between hospital and community care.
Interventions
None listed
Sponsors
Hôpital NOVO
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients who died between January 1, 2024, and December 31, 2024, in the hospital or in their personal living space (home, nursing home...) * Having "palliative care" status in their medical record * Receiving care at one of the six NOVO hospital sites (Pontoise, Magny-en-Vexin, Beaumont-sur-Oise, Marines, Saint-Martin-du-Tertre, Aincourt) * Whether or not they were followed by a mobile palliative care team
Exclusion criteria
None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number and profiles of patients identified as receiving palliative care who died in 2024 within the NOVO Hospital network | Through study completion, an average of 3 months | Description of the sociodemographic, clinical, and organizational characteristics of patients identified as receiving palliative care, including age, sex, living situation, level of autonomy, primary disease, comorbidities, presence of advance directives, and existence of a documented care plan. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Place of death and concordance with patient preferences | Through study completion, an average of 3 months | Assessment of the actual place of death (hospital, home, nursing home or other setting) and comparison with the place of death expressed in advance directives or documented care plans when available |
| Involvement of general practitioners in palliative care management | Through study completion, an average of 3 months | Evaluation of the presence of a primary care physician and their involvement in the patient's palliative care pathway, including participation in care planning and coordination with hospital teams |
| Healthcare utilization in the last months of life | At the end of the study, an average of 3 months | Number of hospital admissions and emergency department visits during the last six months of life |
| Timing of referral to palliative care | Through study completion, an average of 3 months | Time interval between the identification of a palliative situation and the first contact with palliative care services. |
| Explore ways to improve the early identification of palliative care needs and ensure continuity of care between home and hospital | Through study completion, an average of 3 months | Time between the date of death and the start of palliative care |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORMathilde BRUN, Doctor
NOVO
PRINCIPAL_INVESTIGATORThomas AKPAN, Doctor
NOVO
Outcome results
None listed