Knowledge of the patient's bio-psycho-social context as a predictive tool for outcomes in palliative care.

Abstract

The General Practitioner (GP), thanks to his knowledge of the patient's bio-psycho-social context, has a fundamental role in the definition of a personalized care planning (Pcp). The HexCom model can be a valid tool for standardizing the level of complexity of the patient in palliative care and for evidentiate critical care issues. The GP participants retrospectively assessed, using HexCom model, the complexity of the biopsycho-social context of 53 patients taken care by the Palliative Care Unit and who died in the years 2019-2021. For each patient, age, sex, treating doctor, main diagnosis, data and place of death (home/hospice/hospital) were collected. Subjects who died in hospital or hospice had similar HexCom complexity scores, higher than those who died at home (p=0.04). The HexCom score was inversely related to the subject's age (p=0.01). The ROC curve suggested a cut-off for HexCom equal to 209, whereby subjects with HexCom ≥209 would be associated with death in hospital/hospice while subjects with HexCom <209 would be associated with death at home. The present study confirms the importance of evaluating the complexity of a patient in palliative care and proposes the use of the HexCom model for the evaluation of the biopsycho-social context, a predictor of the outcome of a patient in palliative care. bio-psycho-social, complexity, GP, HexCom, palliative care, Pcp.