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One year mortality after hospital admission as an indicator of palliative care need in the Western Cape, South Africa: an incident cohort study

Background: Globally there is an increasing awareness of the need for end-of-life care and palliative care in hospitalized patients that are in their final year of life. However, limited data are available in low and middle income countries which hinders the design and implementation of effective po...

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Main Author: Frankenfeld, Petronella
Other Authors: Raubenheimer, Peter
Format: Thesis
Language:English
Published: Department of Medicine 2020
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access_status_str Open Access
author Frankenfeld, Petronella
author2 Raubenheimer, Peter
author_browse Frankenfeld, Petronella
Raubenheimer, Peter
author_facet Raubenheimer, Peter
Frankenfeld, Petronella
author_sort Frankenfeld, Petronella
collection Thesis
description Background: Globally there is an increasing awareness of the need for end-of-life care and palliative care in hospitalized patients that are in their final year of life. However, limited data are available in low and middle income countries which hinders the design and implementation of effective policies and health services for this patient group. Aim: To determine the proportion of patients who die within one year from their date of admission to hospital in public hospitals in South Africa. Design: Retrospective incident cohort study using record linkage of admission and mortality data. Setting: 46 acute care public hospitals in the Western Cape Province of South Africa. Results: Of the 10 761 patients (median age 44 years; IQR: 31 - 60) admitted to 46 hospitals over a 2 week period in March 2012, 1570 (14.6%) died within one year, the majority of the deaths occurring within the first 3 months. Mortality rose steeply with age as expected. The median age of death was 57.5 years; IQR: 45 - 70. A greater proportion of patients admitted to medical beds died in one year (21.3%) as compared with surgical beds (7.7%). Conclusion: Despite a median age under 60 years at admission, a large percentage of patients admitted to public sector hospitals in South Africa, an upper-middle income country with a high HIV and non-communicable disease burden, are in the final year of their lives. This finding highlights the need for planning and implementation of end-of-life and palliative care strategies for hospitals and patients.
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language eng
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2020
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spelling oai:open.uct.ac.za:11427/32259 One year mortality after hospital admission as an indicator of palliative care need in the Western Cape, South Africa: an incident cohort study Frankenfeld, Petronella Raubenheimer, Peter Medicine Background: Globally there is an increasing awareness of the need for end-of-life care and palliative care in hospitalized patients that are in their final year of life. However, limited data are available in low and middle income countries which hinders the design and implementation of effective policies and health services for this patient group. Aim: To determine the proportion of patients who die within one year from their date of admission to hospital in public hospitals in South Africa. Design: Retrospective incident cohort study using record linkage of admission and mortality data. Setting: 46 acute care public hospitals in the Western Cape Province of South Africa. Results: Of the 10 761 patients (median age 44 years; IQR: 31 - 60) admitted to 46 hospitals over a 2 week period in March 2012, 1570 (14.6%) died within one year, the majority of the deaths occurring within the first 3 months. Mortality rose steeply with age as expected. The median age of death was 57.5 years; IQR: 45 - 70. A greater proportion of patients admitted to medical beds died in one year (21.3%) as compared with surgical beds (7.7%). Conclusion: Despite a median age under 60 years at admission, a large percentage of patients admitted to public sector hospitals in South Africa, an upper-middle income country with a high HIV and non-communicable disease burden, are in the final year of their lives. This finding highlights the need for planning and implementation of end-of-life and palliative care strategies for hospitals and patients. 2020-09-14T13:19:03Z 2020-09-14T13:19:03Z 2020 2020-09-14T11:13:07Z Master Thesis Masters MMed http://hdl.handle.net/11427/32259 eng application/pdf Department of Medicine Faculty of Health Sciences
spellingShingle Medicine
Frankenfeld, Petronella
One year mortality after hospital admission as an indicator of palliative care need in the Western Cape, South Africa: an incident cohort study
thesis_degree_str Master's
title One year mortality after hospital admission as an indicator of palliative care need in the Western Cape, South Africa: an incident cohort study
title_full One year mortality after hospital admission as an indicator of palliative care need in the Western Cape, South Africa: an incident cohort study
title_fullStr One year mortality after hospital admission as an indicator of palliative care need in the Western Cape, South Africa: an incident cohort study
title_full_unstemmed One year mortality after hospital admission as an indicator of palliative care need in the Western Cape, South Africa: an incident cohort study
title_short One year mortality after hospital admission as an indicator of palliative care need in the Western Cape, South Africa: an incident cohort study
title_sort one year mortality after hospital admission as an indicator of palliative care need in the western cape south africa an incident cohort study
topic Medicine
url http://hdl.handle.net/11427/32259
work_keys_str_mv AT frankenfeldpetronella oneyearmortalityafterhospitaladmissionasanindicatorofpalliativecareneedinthewesterncapesouthafricaanincidentcohortstudy