Increase in hospital care at the end of life: Retrospective analysis of the last 20 years of life of a cohort of patients

Alberto Jiménez-Puente; María Dolores Martín-Escalante; Francisco Martos-Pérez; Javier García-Alegría

doi:10.1016/j.regg.2024.101484

Increase in hospital care at the end of life: Retrospective analysis of the last 20 years of life of a cohort of patients

Rev Esp Geriatr Gerontol. 2024 Mar 28;59(3):101484. doi: 10.1016/j.regg.2024.101484. Online ahead of print.

Authors

Alberto Jiménez-Puente¹, María Dolores Martín-Escalante², Francisco Martos-Pérez², Javier García-Alegría³

Affiliations

¹ Hospital Costa del Sol, Unidad de Evaluación, Marbella, Málaga, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Marbella, Málaga, Spain; IBIMA Plataforma BIONAND, Marbella, Málaga, Spain. Electronic address: josealberto.jimenez.puente.sspa@juntadeandalucia.es.
² Hospital Costa del Sol, Área de Medicina Interna, Marbella, Málaga, Spain.
³ Hospital Costa del Sol, Área de Medicina Interna, Marbella, Málaga, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Marbella, Málaga, Spain; IBIMA Plataforma BIONAND, Marbella, Málaga, Spain.

PMID: 38552406
DOI: 10.1016/j.regg.2024.101484

Abstract

Background: There is an increasing need for end-of-life care due to society's progressive aging. This study aimed to describe how hospitalizations evolve long-term and in the last months life of a cohort of deceased patients.

Methods: The study population were those who died in one year who lived in a district in southern Spain. The number of hospital stays over the previous 20 years and number of contacts with the emergency department, hospitalization, outpatient clinics, and medical day hospital in the last three months of life were determined. The analyses were stratified by age, sex, and pattern of functional decline.

Results: The study population included 1773 patients (82.5% of all who died in the district). The hospital stays during the last 20 years of life were concentrated in the last five years (66%) and specially in the last six months (32%). Eighty percent had contact with the hospital during their last three months of life. The older group had the minimun of stays over the last 20 years and contacts with the hospital in the last months of life.

Conclusions: The majority of hospitalizations occur at the end of life and these admissions represent a significant part of an acute-care hospital's activity. The progressive prolongation of life does not have to go necessarily along with a proportional increase in hospital stays.

Keywords: Atención hospitalaria; Cuidados al final de la vida; Cuidados terminales; End-of-life care; Healthcare services; Hospital care; Mortalidad; Mortality; Servicios de salud; Terminal care.