Lieve Van den Block|Lara Pivodic|Koen Pardon|Gé Donker|Guido Miccinesi|Sarah Moreels|Tomás Vega Alonso|Luc Deliens|Bregje D. Onwuteaka-Philipsen
Transitions between health care settings in the final three months of life in four EU countries
Vrije Universiteit Brussel|Ghent University|Vrije Universiteit Brussel|Ghent University|Vrije Universiteit Brussel|Ghent University|Netherlands Institute for Health Services Research|Piedmont Reference Center for Epidemiology and Cancer Prevention|Institut Scientifique de Santé Publique|Ministry of Health|Vrije Universiteit Brussel|Ghent University|EMGO Institute for Health and Care Research
background transitions care settings may related poor quality endoflife care yet lack crossnational populationbased data transitions end life method international mortality followback study data collection belgium netherlands italy spain 200911 via existing representative epidemiological surveillance networks general practitioners gps general practitioners reported weekly standardized registration form every deceased patient 18 years practice identified died nonsuddenly results among 4791 nonsudden deaths belgium netherlands italy spain 59 55 60 58 respectively transferred care settings least final 3 months life 10 8 10 13 final 3 days life 10 5 8 12 transferred three times p 0001 multivariate analyses adjusting country differences age sex cause death presence dementia countries transitions frequent among patients residing home 6173 among patients residing care home 3340 three months death 57 patients hospital rose 2739 day death patient wishes cited reason last transition death 27 39 9 6 cases belgium netherlands italy spain respectively p 0001 conclusion endoflife transitions health care settings common across eu countries particular late hospitalizations people residing home frequency type reasons terminal hospitalizations vary countries