Transmural care. A new approach in the care for terminal cancer patients: its effects on re-hospitalization and quality of life

Patient Educ Couns. 1998 Nov;35(3):189-99. doi: 10.1016/s0738-3991(98)00062-7.

Abstract

Despite their wishes, terminal cancer patients are frequently readmitted to hospitals. This appears in part to be due to poor communication amongst professional caregivers and/or the overburdening of their (informal) caregivers. This quasi-experimental study investigated the effects of a transmural home care programme on re-hospitalization, quality of life and place of death for terminal cancer patients. The programme intended to optimize communication, cooperation and coordination between intra- and extra-mural health care organizations (transmural care). Initial patient characteristics of the intervention group (n = 79) matched those of the control group (n = 37) well. When compared to the control group, which received the standard community care, patients in the intervention group underwent significantly less re-hospitalization during the terminal phase of their illness (5.8 versus 11.5 days; P < 0.01) while the intervention contributed significantly positive to the patients' "physical" quality of life 1 month after the start of the intervention. A higher, but not significant (P = 0.06) percentage of patients in the intervention group also died at home (81 versus 65%). The introduction of measures to enhance coordination and cooperation of intra- and extramural care, seems to be an improvement compared to standard community care.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Community Health Nursing / organization & administration
  • Continuity of Patient Care / organization & administration
  • Female
  • Home Care Services / organization & administration*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / psychology
  • Neoplasms / therapy*
  • Netherlands
  • Patient Readmission / statistics & numerical data*
  • Program Evaluation
  • Quality of Life*
  • Terminal Care / organization & administration*