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The use of hospital-based services by heart failure patients in the last year of life: a discussion paper

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Abstract

Individuals with chronic heart failure have high utilisation of hospital-related services towards the end of life and receive treatments that provide symptom relief without improving life expectancy. The aim of this discussion paper is to determine chronic heart failure patients’ use of acute hospital-based services in their last year of life and to discuss the potential for palliative care to reduce service utilisation. A systematic search of the literature was conducted. Medline, Cumulative Index for Nursing and Allied Health (CINAHL) and SCOPUS databases were used to systematically search for literature from database commencement to September 2016. Specific inclusion criteria and search terms were used to identify relevant studies on heart failure patients’ use of hospital services in their last year of life. There were 12 studies that evaluated the use of hospital-based services by chronic heart failure patients at the end of life. In all studies, it was found that chronic heart failure patients used acute hospital-based services as death approached. However, only two studies examined if palliative care consultations were obtained by patients, and neither study assessed the impact that these consultations had on service utilisation in the last year of life. Heart failure negatively impacts health status, and this is a predictor of service utilisation. Further research is needed to determine the efficacy of both primary and secondary palliative care in reducing resource use towards the end of life and improving the quality of end of life care.

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Authors and Affiliations

  1. School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia

    Gursharan K. Singh, Patricia M. Davidson & Phillip J. Newton

  2. School of Nursing, Johns Hopkins University, 525 N Wolfe St, Baltimore, MD, 21205, USA

    Patricia M. Davidson

  3. Heart Transplantation Unit, St Vincent’s Hospital, 390 Victoria St, Darlinghurst, NSW, 2010, Australia

    Peter S. Macdonald

  4. Victor Chang Cardiac Research Institute, Lowy Packer Building 405 Liverpool Street, Darlinghurst, NSW, 2010, Australia

    Peter S. Macdonald

  5. University of New South Wales, Sydney High St, Kensington, NSW, 2052, Australia

    Peter S. Macdonald

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Singh, G.K., Davidson, P.M., Macdonald, P.S. et al. The use of hospital-based services by heart failure patients in the last year of life: a discussion paper. Heart Fail Rev 24, 199–207 (2019). https://doi.org/10.1007/s10741-018-9751-7

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