Demonstrative model for early identification and continuous care of cancer patients with palliative needs

Abstract

INTRODUCTION: Palliative care (PC) was incorporated into the public health of many countries with great variability and inequity. Argentina has a medium-high incidence of cancer and the National Palliative Care Program does not identify the  target population. The NECPAL CCOMS-ICO© tool identifies patients with palliative needs. It combines a reflexive question  (Would you be surprised if your patient died in the next year?) with specific indicators. The objective of this study was the early  identification and improvement of comprehensive care for patients with cancer and palliative needs. The implementation of a  health care intervention is reported (Palliative Care Model Program). METHODS: All cancer patients from the hospital (July 2014- 2016) were included. Their 10 physicians were interviewed in 69 individual sessions with NECPAL. A 4-stage demonstration  program was designed. RESULTS: There were 317 patients, 57% with palliative needs (NECPAL+). As a result of the  implementation, 94% (n=172) of the 183 NECPAL+ patients were referred to PC (versus 28% before the program); there was a  mean follow-up time of 7.4 months and 183 people died (28 at home). The quality standards of structure, process and outcome  were exceeded. DISCUSSION: For the first time in Argentina, this health care intervention allowed almost all cancer patients  with early palliative needs to be included in a program of continuous care until death in hospital or at home.