While the positive impact of early palliative care on the quality of life of cancer patients is well established, there is a noticeable research gap in developing countries. This study sought to determine the impact of an outpatient palliative care (OPC) program on the location of death among patients in Brazil. This was a retrospective study including patients with cancer who died between January 2022 and December 2022 in 32 private cancer centers in Brazil. Data were collected from medical records, encompassing demographics, cancer characteristics, and participation in the OPC program. The study involved 1980 patients, of which 32.3% were in the OPC program. OPC patients were predominantly younger (average age at death of 66.8 vs. 68.0 years old,p= 0.039) and composed of women (59.4% vs. 51.3%,p= 0.019) compared to the no-OPC patients. OPC patients had more home/hospice deaths (19.6% vs. 10.4%,p< 0.001), and participation in the outpatient palliative care program strongly predicted home death (OR: 2.02, 95% CI: 1.54–2.64). Our findings suggest a significant impact of the OPC program on increasing home and hospice deaths among patients with cancer in our sample. These findings emphasize the potential of specialized OPC programs to enhance end-of-life care, particularly in low-resource countries facing challenges related to social and cultural dimensions of care and healthcare access.
尽管早期姑息治疗对癌症患者生活质量的积极影响已得到广泛认可，但在发展中国家相关研究仍存在明显空白。本研究旨在探讨门诊姑息治疗项目对巴西患者死亡地点的影响。这项回顾性研究纳入了2022年1月至2022年12月期间在巴西32家私立癌症中心去世的癌症患者，通过医疗记录收集人口统计学特征、癌症相关信息及门诊姑息治疗参与情况。研究共纳入1980例患者，其中32.3%参与了门诊姑息治疗项目。与非项目参与者相比，项目参与者中位死亡年龄更年轻（66.8岁 vs 68.0岁，p=0.039），女性比例更高（59.4% vs 51.3%，p=0.019）。项目参与者的家庭/临终关怀机构死亡比例显著更高（19.6% vs 10.4%，p<0.001），且参与门诊姑息治疗项目是家庭死亡的重要预测因素（OR：2.02，95% CI：1.54–2.64）。研究结果表明，门诊姑息治疗项目显著提高了本样本中癌症患者的家庭及临终关怀机构死亡比例。这些发现凸显了专业化门诊姑息治疗项目在改善临终关怀质量方面的潜力，特别是在面临社会文化维度照护挑战及医疗资源可及性问题的中低收入国家。
Outpatient Palliative Care Program: Impact on Home Death Rate in Brazil
肿瘤(癌症)患者之家