Impact of the Regional Palliative Care Pathway on Emergency Room Visits and Hospitalizations

Abstract

To explore the effect of palliative care (PC) pathway including home care and end-of-life care beds in the community hospitals supported by a PC unit in the secondary hospital on ER visits and hospitalizations. Patients with advanced cancer and no further oncologic therapies who visited the ER of the Hyvinkää hospital before (2009) and after (2015) the establishment of the PC pathway were evaluated. A total of 112 patients visited the ER in both years, but revisits decreased from 59% to 38% (p<0.01). The most common symptoms necessitating the visit were pain (20%) and dyspnoea (14%). The proportion of patients admitted to a secondary hospital were 56% and 45% (p=0.016) and to community hospitals 12% and 28% (p<0.001) in 2009 and 2015, respectively. Organizing a PC pathway for cancer patients together with primary and secondary care decreases revisits to ER and admissions to secondary hospitals.