Home Care Support Teams: The experience of the PADES
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Institut Català d’Oncologia ICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes Home Care Support Teams: The experience of the PADES Jose Espinosa. MD. Coordinator of The ‘Qualy’ End of Life Care Observatory WHO Collaborating Centre for Public Health Palliative Care Programmes Institut Català d’Oncologia 10 th March 2011 .
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. Home Care Support Teams: The experience of the PADES. Jose Espinosa. MD. Coordinator of The ‘ Qualy ’ End of Life Care Observatory WHO Collaborating Centre for Public Health Palliative Care Programmes Institut Català d’Oncologia 10 th March 2011. St Christopher’s Program (1980 ) - PowerPoint PPT Presentation
Transcript of Home Care Support Teams: The experience of the PADES
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
Home Care Support Teams: The experience of the
PADES
Jose Espinosa. MD.Coordinator of The ‘Qualy’ End of Life Care Observatory
WHO Collaborating Centre for Public Health Palliative Care Programmes
Institut Català d’Oncologia
10th March 2011
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Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
• St Christopher’s Program (1980 )• Home Care Program – General Hospital of Vic (1984)• Bloomsbury Home Care Support Team (1986)• Home Care Support Program - Hospital Sta Creu Vic
(1987)• Centers & Sociohealth services Program (1989)
(DOGC núm. 1348 de 1990, DOGC núm. 3597 de 2002. )
• Another new Home Care Support Team in Spain.1990 – 1998 UCP-AECC, ESAD- Insalud
History of HCST
Institut Català d’Oncologia
Home Care support teamsin Catalonia
• Number• Structure• Activity• Clinical results: Effectiveness• Other Results: Efficiency• Other results: Satisfaction
Institut Català d’Oncologia
Resources of PC in Catalonia 2010
TYPE OF RESOURCE N
Home Care Support teams PADES
72
UCP : 60
HA: 5
SS: 28
MEP: 27
ESH 49
CCEE/HD51
EAPS 5
NASS 3
TOTAL 237
Source: The End-of-Life “QUALY” Observatory 2009 (*)
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
• Because it is the preference of patient & family
• When the Complexity of the situation allows Home Care
• If the Support Team have the right training level
Needs of PC at Home
Institut Català d’Oncologia
Catalonia and Spain
2008 N %
Catalonia 72 41%
Other Spanish regions 104 39 %
Total in Spain 176 100
Source: SECPAL Directory
Institut Català d’Oncologia
Structure
• 1 Doctor (mean: 1.28)
• 2 nurses (mean: 2.3)
• 1 social worker (mean: 1)
Source: The End-of-Life “QUALY” Observatory 2009
Institut Català d’Oncologia
Activity
• New patients: 270
• Most transfered by GPs
• 50% shared care
• 50% cancer / noncancer
• Length of intervention: 70-80 days
• 1-3 interventions / week
• Phone calls the second most frequent
• Ratio 1st / visits : 1 / 8
Source: The End-of-Life “QUALY” Observatory 2009
Institut Català d’Oncologia
Quantitative Results of PADES in Catalunya 2008
Type of Activity N: PADES % de PADES
Outpatients 16 29,09
PC Teams Consultancy 52 94,55
Primary Care Consultancy 31 56,36
24 Hours Phone 5 9,09
24 Hours Care 6 10,91
Direct Hospital Care 16 29,09
Hospital Support 21 38,18
Activity Mean
1st Visit 233,09
2on Visit 1.973,33
Ratio 8,46
Phone Support 1.422,02
Source: The End-of-Life “QUALY” Observatory 2009
Institut Català d’Oncologia
Specialist PCHST in SpainMed. Clinica 2010.
EspinosaJ., Gomez-Batiste X., Picaza JM., Limón E.
Institut Català d’Oncologia
Clinical results: effectiveness
Institut Català d’Oncologia
Clinical results: Effectiveness Specialist PCHST in Spain Med. Clinica 2010.
EspinosaJ., Gomez-Batiste X., Picaza JM., Limón E.
Significant reduction of all symptoms at 7 and 14 days
Institut Català d’Oncologia
Efficiency
Institut Català d’Oncologia
PCHT as a cost-saving alternative Serra-Prat M., Gallo P.,Picaza JM. Palliative Medicine 2001
1.000 euros / patient / month
Institut Català d’Oncologia
Results: Use of resources Specialist PCHST in Spain Med. Clinica 2010.
EspinosaJ., Gomez-Batiste X., Picaza JM., Limón E
• Reduction hospital admissions
• Reduction of length stay
• Reduction Use emergencies
• Reduction cost: 3.200euros / patient / process
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Death at home: From 30% to 68%
Programmed admissions: from 30% to 72%
Results: Use of resources Specialist PCHST in Spain Med. Clinica 2010.
EspinosaJ., Gomez-Batiste X., Picaza JM., Limón E
Institut Català d’Oncologia
PADES:
The highest satisfaction of services
Catsalut survey, 2008
Institut Català d’Oncologia
Qualitative analysis: Strengths, weaknesses of PADES in Catalunya
Strengths Areas improvement
• Effectiveness
• Reduction hospital admissions, stays, and emergencies
• Proportion noncancer reaching 50%
• Planned vs emergency admissions
• Increase % death at home
• Reduction > 50% costs
• High Satisfaction
• Continuing care
• Emergency out of hours
• Research
• Psychological support
• Care of the relatives: bereavement, volonteers, informal care
Institut Català d’OncologiaICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes
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The ‘Qualy’ End of Life Care Observatory WHO Collaborating Centre for Public Health Palliative Care Programmes
[email protected]+34 93 260 77 36
ICO l’HospitaletHospital Duran i ReynalsGran Via de l’Hospitalet, 199-20308908 l’Hospitalet de Llobregat
Institut Català d’Oncologia
