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Home Care Support Teams: The experience of the PADES

. Home Care Support Teams: The experience of the PADES. Jose Espinosa. MD. Coordinator of The ‘ Qualy ’ End of Life Care Observatory WHO Collaborating Centre for Public Health Palliative Care Programmes Institut Català d’Oncologia 10 th March 2011. St Christopher’s Program (1980 )

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Home Care Support Teams: The experience of the PADES

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  1. . Home Care Support Teams: The experience of the PADES Jose Espinosa. MD. Coordinator of The ‘Qualy’ End of Life Care Observatory WHO Collaborating Centre for Public Health Palliative Care Programmes InstitutCatalàd’Oncologia 10th March 2011 ICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes

  2. St Christopher’s Program (1980 ) Home Care Program – General Hospital of Vic (1984) Bloomsbury Home Care Support Team (1986) Home Care Support Program - Hospital StaCreu Vic (1987) Centers & Sociohealth services Program (1989) (DOGC núm. 1348 de 1990, DOGC núm. 3597 de 2002. ) Another new Home Care Support Team in Spain. 1990 – 1998 UCP-AECC, ESAD- Insalud History of HCST ICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes

  3. Home Care support teamsin Catalonia Number Structure Activity Clinical results: Effectiveness Other Results: Efficiency Other results: Satisfaction

  4. Resources of PC in Catalonia 2010 Source: TheEnd-of-Life “QUALY” Observatory 2009 (*)

  5. Needs of PC at Home • Because it is the preference of patient & family • When the Complexity of the situation allows Home Care • If the Support Team have the right training level ICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes

  6. Catalonia and Spain Source: SECPAL Directory

  7. Structure • 1 Doctor (mean: 1.28) • 2 nurses (mean:2.3) • 1 social worker(mean: 1) Source: TheEnd-of-Life “QUALY” Observatory 2009

  8. Activity • New patients: 270 • Most transfered by GPs • 50% shared care • 50% cancer / noncancer • Length of intervention: 70-80 days • 1-3 interventions / week • Phone calls the second most frequent • Ratio 1st / visits : 1 / 8 Source: TheEnd-of-Life “QUALY” Observatory 2009

  9. Quantitative Resultsof PADES in Catalunya 2008 Source: TheEnd-of-Life “QUALY” Observatory 2009

  10. Specialist PCHST in SpainMed. Clinica 2010.EspinosaJ., Gomez-Batiste X., Picaza JM., Limón E.

  11. Clinical results: effectiveness

  12. Clinical results: Effectiveness Specialist PCHST in Spain Med. Clinica 2010.EspinosaJ., Gomez-Batiste X., Picaza JM., Limón E. Significant reduction of all symptoms at 7 and 14 days

  13. Efficiency

  14. PCHT as a cost-saving alternativeSerra-Prat M., Gallo P.,Picaza JM.Palliative Medicine 2001 1.000 euros / patient / month

  15. Results: Use of resources Specialist PCHST in Spain Med. Clinica 2010.EspinosaJ., Gomez-Batiste X., Picaza JM., Limón E • Reduction hospital admissions • Reduction of length stay • Reduction Use emergencies • Reduction cost: 3.200euros / patient / process

  16. Results: Use of resources Specialist PCHST in Spain Med. Clinica 2010.EspinosaJ., Gomez-Batiste X., Picaza JM., Limón E Death at home: From 30% to 68% Programmed admissions: from 30% to 72%

  17. PADES:The highest satisfaction of servicesCatsalut survey, 2008

  18. Qualitative analysis: Strengths, weaknesses of PADES in Catalunya

  19. . The ‘Qualy’ End of Life Care Observatory WHO Collaborating Centre for Public Health Palliative Care Programmes whocc.info@iconcologia.net +34 93 260 77 36 Institut Català d’Oncologia ICO l’Hospitalet Hospital Duran i Reynals Gran Via de l’Hospitalet, 199-203 08908 l’Hospitalet de Llobregat ICO DiR. The ‘Qualy’ End of Life Care Observatory - WHO Collaborating Centre for Public Health Palliative Care Programmes

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