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Community-based palliative care is associated with reduced emergency department use by people with dementia in their last year of life: A retrospective cohort study
Rosenwax L, Spilsbury K, Arendts G, McNamara B, Semmens J.. Palliative medicine, 2015-03-17
Topic: Risk, prevention and care in population studies
Objective To describe patterns in the use of hospital emergency departments in the last year of life by people who died with dementia and whether this was modified by use of community-based palliative care. Design Retrospective population-based cohort study of people in their last year of life. Time-to-event analyses were performed using cumulative hazard functions and flexible parametric proportional hazards regression models. Setting/participants All people living in Western Australia who died with dementia in the 2-year period 1 January 2009 to 31 December 2010 (dementia cohort; N = 5261). A comparative cohort of decedents without dementia who died from other conditions amenable to palliative care (N = 2685). Results More than 70% of both the dementia and comparative cohorts attended hospital emergency departments in the last year of life. Only 6% of the dementia cohort used community-based palliative care compared to 26% of the comparative cohort. Decedents with dementia who were not receiving community-based palliative care attended hospital emergency departments more frequently than people receiving community-based palliative care. The magnitude of the increased rate of emergency department visits varied over the last year of life from 1.4 (95% confidence interval: 1.1-1.9) times more often in the first 3 months of follow-up to 6.7 (95% confidence interval: 4.7-9.6) times more frequently in the weeks immediately preceding death. Conclusions Community-based palliative care of people who die with or of dementia is relatively infrequent but associated with significant reductions in hospital emergency department use in the last year of life.
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APA 7th
Rosenwax, L., Spilsbury, K., Arendts, G., McNamara, B., & Semmens, J. (2015). Community-based palliative care is associated with reduced emergency department use by people with dementia in their last year of life: A retrospective cohort study. Palliative medicine. https://doi.org/10.1177/0269216315576309
Vancouver
Rosenwax L, Spilsbury K, Arendts G, McNamara B, Semmens J. Community-based palliative care is associated with reduced emergency department use by people with dementia in their last year of life: A retrospective cohort study. Palliative medicine. 2015. doi:10.1177/0269216315576309. PMID: 25783598.
BibTeX
@article{rosenwax2015-25783598,
author = {Rosenwax, L. and Spilsbury, K. and Arendts, G. and McNamara, B. and Semmens, J.},
title = {{Community-based palliative care is associated with reduced emergency department use by people with dementia in their last year of life: A retrospective cohort study}},
journal = {Palliative medicine},
year = {2015},
doi = {10.1177/0269216315576309},
pmid = {25783598},
url = {https://doi.org/10.1177/0269216315576309}
}
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Key findings
- Results More than 70% of both the dementia and comparative cohorts attended hospital emergency departments in the last year of life.
- Only 6% of the dementia cohort used community-based palliative care compared to 26% of the comparative cohort.
- Conclusions Community-based palliative care of people who die with or of dementia is relatively infrequent but associated with significant reductions in hospital emergency department use in the last year of life.
Study details
- Study designcohort study
- Participants5,261
- Evidence strengthModerate
How this study scored 66/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for effect reported and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 38 of the 58 points we could judge it on, which is 66 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Palliative medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 7 / 12 | A cohort study following people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2015 — within 20 year(s) of the newest study here |
| Sample size | 3 / 4 | 5,261 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 25783598) |
| Free to read | 2 / 2 | Free to read |
| Points | 38 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 38 of the 58 points we could judge it on is 66 out of 100. |
| Total | 66 / 100 | — |
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