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GP awareness of preferred place of death and correlates of dying in a preferred place: a nationwide mortality follow-back study in the Netherlands.

Abarshi, E., Onwuteaka-Philipsen, B., Donker, G., Echteld, M., Block, L. van den, Deliens, L. GP awareness of preferred place of death and correlates of dying in a preferred place: a nationwide mortality follow-back study in the Netherlands. SMW: Schweizerische Medizinische Wochenschrift: 2009, 139(Suppl. 175), p. S 43. 15th Wonca Europe Conference, 16-19 september 2009, Basel (Switzerland).
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Background: To improve the quality of end-of-life care, general practitioner (GP) awareness of where their patients prefer to die is important. Objective: To examine GP awareness of patients’ preferred place of death (POD), associated patient and care-related characteristics, and the congruence between preferred and actual POD in The Netherlands. Methods:A mortality follow-back study was conducted between January 2005 and December 2006. Standardized registration forms were used to collect data on all non-sudden deaths (n = 637) via the Dutch Sentinel Network, a nationally representative network of general practices. Results: Forty-six percent of patients had GPs who were not aware of their preferred POD. Of those whose GPs were aware, 88% had preferred to die in a private or care home, 10% in a hospice or palliative care unit and 2% in a hospital. GPs were informed by the patients themselves in 84% of cases. Having financial status ‘above average’, a life-prolongation or palliative care goal, and using specialist palliative care services were associated with higher GP-awareness odds. Four-fifth of patients with known preferred POD died there. Conclusion: There is a potential for improving GP awareness of patients’ preferred POD. Such awareness is enhanced when palliation is an active part of end-of-life care. The hospital is the POD least preferred by dying patients. (aut. ref.)
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