1 / 17

END-OF-LIFE CARE IN A PHYSICIAN’S WORK IN FINNISH HEALTH CENTRES

END-OF-LIFE CARE IN A PHYSICIAN’S WORK IN FINNISH HEALTH CENTRES. Kosunen E, Hautala K, Fält A, Hinkka H, Lammi UK, Kellokumpu-Lehtinen P. Medical School University of Tampere Finland. Background.

hu-williams
Download Presentation

END-OF-LIFE CARE IN A PHYSICIAN’S WORK IN FINNISH HEALTH CENTRES

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. END-OF-LIFE CARE IN A PHYSICIAN’S WORK IN FINNISH HEALTH CENTRES Kosunen E, Hautala K, Fält A, Hinkka H, Lammi UK, Kellokumpu-Lehtinen P. Medical School University of Tampere Finland

  2. Background • Even if age-adjusted incidende of cancer diseases remained the same, the total number of cancer patients will increase in the future years in Finland • large age cohorts get old, people live longer, high survival rates (among the best in Europe) • a part of the growing work load will be transferred to primary health care, including end-of-life (EOL) care

  3. Background… End-of-life (EOL) care in Finland: • hospices: only in the biggest cities • secondary care hospitals: • regional hospitals • central hospitals • university hospitals • primary care • hospitals • home care

  4. Aims of the study • To study general practitioners (GPs) involvement in cancer patients’ EOL care in Finnish health centres • To study GPs’ experiences of EOL care • To study GPs’ educational needs related to EOL care

  5. Data collection • A questionnaire was sent by mail in April 2003 • The target group: all health centre physicians in Pirkanmaa Hospital District • One reminded by post • One reminder by e-mail to the chief physicians of the health centres

  6. Material • 319 questionnaires were sent • 196 physicians responded • 55 reported that they did not belong to the target group any more • 141 had completed the questionnaire • the response rate was 53 % (after excluding pollution)

  7. Respondents’ background, % (n=141)

  8. Respondents’ involvement in cancer care (n=141)

  9. Involvement in end-of-life care • 84 % (n=118) had ever treated EOL patients - mostly in primary care • 17 % (n=24) had at least one EOL patient at the moment

  10. Collaboration with hospitals (secondary care) • in general, GPs were satisfied with the collaboration (consultations, help in acute problems) • transfer of information was most often considered as bad or very bad (46%) • Written information on finishing active treatments was often missing

  11. 72 % reported having experienced emotional stress when making ethical decisions in EOL care 12 % much or very much no significant differences by background factors men more than women ! (n.s.) 33 % reported that they had sometimes felt guilty because of EOL decisions Only 34 % had a possibility for supervision Emotional stress (among GPs who had participated in EOL care, n=118)

  12. Economic aspects in EOL care Influence of financial factors was asked related to • treatment of pain (13%) • antiemetic treatment (15%) • specialist consultations (19%) • Influence of financial factors was reported most often related to hospice care (40%)

  13. Need of education and training: proportions of the responses quite/very much (n=118)

  14. Discussion • Response rate was quite low • The respondents were experienced GPs, specialists more often than on average • Probably this means that EOL treatment in PHC is mostly in experienced hands

  15. Conclusions • EOL care is not yet very usual in primary health care • When trying to increase it, good collaboration with secondary care is crucial • Supervision should be available

  16. Thanks for your attention!

More Related