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Good end-of-life care according to patients and their GPs.

Borgsteede, S.D., Graafland-Riedstra, C., Deliens, L., Francke, A.L., Eijk, J.T.M. van, Willems, D.L. Good end-of-life care according to patients and their GPs. British Journal of General Practice: 2006, 56(522), 20-26
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Background: Most patients prefer to die at home, where a GP provides end-of-life care. A few previous studies have been directed at the GPs' values on good end-of-life care, yet no study combined values of patients and their own GP. Aim: To explore the aspects valued by both patients and GPs in end-of-life care at home, and to reflect upon the results in the context of future developments in primary care. Design of study: Interviews with patients and their own GP. Setting: Primary care in the Netherlands. Method: Qualitative, semi-structured interviews with 20 GPs and 30 of their patients with a life expectancy of less than 6 months, and cancer, heart failure or chronic obstructive pulmonary disease as underlying disease. Results: Patients and GPs had comparable perceptions of good end-of-life care. Patients and GPs identified four core items that they valued in end-of-life care: availability of the GP for home visits and after office-hours, medical competence and cooperation with other professionals, attention and continuity of care. Conclusions: Future developments in the organisation of primary care such as the restriction of time for home visits, more part-time jobs and GP cooperatives responsible for care after office hours, may threaten valued aspects in end-of-life care. (aut.ref.)