Integrating palliative care in oncologic emergency departments: Challenges and opportunities

Table 4 Programs to reduce Emergency visits and hospitalization for patients receiving palliative care

Ref./country	Study	Objective	Intervention/observation	Outcome
Prudy et al[36] United Kingdom	Marie curie cancer care DCP	Help PC patients die at home and avoid emergency department visits	(1) Expedited hospital discharges for terminal patients; (2) After hour specialist PC nurses to respond to patients, families, and clinicians	Patients who used DCP are 30% less likely to die in hospital
Wiese et al[40] Germany	Quality of out-of-hospital emergency medical team. Prospective Multicenter Analysis	To evaluate the impact of physician’s expertise in PC and emergency care on the outcome of emergency call for PC patients in the community	Number of ICU admissions, PC unit admission, general ward admission, and discharge after ambulatory care	Physicians with expertise in PC provided a better quality end of life care with less ICU admissions and more PC unit admission
Mercadante et al[39] Italy	Emergencies in patients with advanced cancer followed at home	Assess the frequency and reasons of emergency calls by patients receiving palliative care at home	Characteristic and outcome of consecutive emergency calls	Of 689 patients; 17% made emergency calls. Main reasons were dyspnea, pain, and delirium. Family initiated most calls
Porzio et al[37] Italy	Integrating oncology and palliative home care in Italy	Evaluate efficacy of home care program integrated with a medical oncology unit	Compare outcome of patients from the integrated oncology program to other patients coming from other hospitals	Patients in the integrated program had longer length of stay at home, less emergency calls, less hospitalization, and more death at home
Alonso-Babarro et al[38] Spain	Association between inpatient death, utilization of hospital resources and availability of PC	Evaluate the impact of community PC service on use of hospital resources in 2 areas with and without PC	(1) Use of emergency calls; (2) Hospital death; (3) Emergency visit and hospitalization	Community with PC service had less emergency calls, less hospitalization and inpatient death

ICU: Intensive care unit; PC: Palliative care; DCP: Delivering choice program.