Impact Of A Multidisciplinary Home Palliative Care Unit In The Place Of Death Of Patients Diagnosed With Cancer

45 Background: Home death rate is increasingly being used as a quantifiable indicator of the effectiveness of palliative care services. Intensifying home care and training of the end-of-life care practitioners, seems to be the way to improve the correlation between patient preferences and actual place of death. The objective of this study is to measure the impact of a multidisciplinary home palliative care unit (HPCU) (including medical, nursery, and psycological care, and social worker counselling) on the place of death of patients treated in a single oncology service. Methods: A retrospective case-control study was performed. HPCU patients consecutively admitted from January 2014 to June 2015 (cases) were matched with contemporary patients from the same center who could be followed by independent support services (Home Hospitalization, Psicooncologists and General Practitioners) (controls) by diagnosis, sex, age group ( < 60 years, 61-75y and > 75y) and oncologist physician. Place of death was registered. Odds ratio (ORR) and relative risk was analysed with SPSS for Windows ver.22.00. Results: Seventy four patients (p) admitted in a HPCU and their controls were included; 54% men; Average of age in cases 69.7years (y) (SD 10.8) and controls 68.5 y (SD 10.41), diagnosed of lung cancer 20p (27%), breast cancer 6p (8%), gastrointestinal noncolorectal cancer 16p (22%), colorectal cancer 10p (13.5%), head and neck cancer 5p (6.8%), genitourinary cancer 12p (16%), metastatic melanoma 2p, advanced sarcoma 2p and unknown primary cancer 1p. Place of death: home (cases 43p [59%], controls 8p [10%]); emergency service (1p [1.4%] vs 3p [4.1%]); in acute hospital in-patient-care (AH) (11p [15.1%] vs 29 p [39.2%]) and at a hospitalized palliative care unit (18p [24.7%], vs 34p [45.9%]); 1p of case group was lost during follow-up. The ORR for dying at home for HPCU patients was 11.82 (IC 95% 4.95-28.02) and a reduction in risk of die in an AH was seen (0.38, IC 95% 0.21-0.67). Conclusions: Death at home seems to be more feasible if cancer diagnosed patients have a proper follow-up by a multidisciplinary home palliative care unit, and it also reduce the possibility of dying in an acute hospital in-patient-care.