Palliative home care reduces time spent in hospital wards: a population-based study in the Tuscany Region, Italy

BackgroundSeparation from one’s child can have significant consequences for parental health and well-being. We aimed to investigate whether parents whose children were placed in care had higher rates of avoidable mortality.MethodsData were obtained from the Swedish national registers. Mortality rates among parents whose children were placed in care between 1990 and 2012 (17 503 mothers, 18 298 fathers) were compared with a 1:5 matched cohort of parents whose children were not placed. We computed rate differences and HRs of all-cause and avoidable mortality.ResultsAmong mothers, deaths due to preventable causes were 3.09 times greater (95% CI 2.24 to 4.26) and deaths due to amenable causes were 3.04 times greater (95% CI 2.03 to 4.57) for those whose children were placed in care. Among fathers, death due to preventable causes were 1.64 times greater (95% CI 1.32 to 2.02) and deaths due to amenable causes were 1.84 times greater (95% CI 1.33 to 2.55) for those whose children were placed in care. Avoidable mortality rates were higher among mothers whose children were young when placed in care and among parents whose children were all placed in care.ConclusionsParents who had a child placed in out-of-home care are at higher risk of avoidable mortality. Interventions targeting mothers who had a child aged less than 13 placed in care, and parents whose children were all placed in care could have the greatest impact in reducing avoidable mortality in this population.

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Utilization and costs of home care for patients with colorectal cancer: a population-based study

CMAJ Open ◽

10.9778/cmajo.20130026 ◽

2014 ◽

Vol 2 (1) ◽

pp. E11-E17 ◽

Cited By ~ 14

Author(s):

N. Mittmann ◽

N. Liu ◽

J. Porter ◽

S. J. Seung ◽

P. K. Isogai ◽

...

Keyword(s):

Colorectal Cancer ◽

Home Care ◽

Population Based ◽

Population Based Study

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Home care of a child dying of a malignancy and parental awareness of a child’s impending death

Palliative Medicine ◽

10.1191/0269216306pm1139oa ◽

2006 ◽

Vol 20 (3) ◽

pp. 161-169 ◽

Cited By ~ 35

Author(s):

Pamela J Surkan ◽

Paul W Dickman ◽

Gunnar Steineck ◽

Erik Onelöv ◽

Ulrika Kreicbergs

Keyword(s):

Pain Relief ◽

Home Care ◽

Population Based ◽

Physical Symptoms ◽

Postal Questionnaire ◽

Population Based Study ◽

Parental Awareness ◽

Imminent Death ◽

Dying At Home ◽

At Home

In this population-based study, we found that parents who are aware that their child will die from a malignancy are more likely to care for their child at home during the child’s last month of life compared to parents who are not aware. End-of-life home care was comparable to hospital care for satisfactory pain relief, access to pain relief and access to medications for other physical symptoms. Using an anonymous postal questionnaire, we obtained information from 449 parents in Sweden who had lost a child due to a malignancy between 1992 and 1997, 4 to 9 years before participating in our study. The prevalence of dying at home and being cared for at home during the last month of life was 23.7% when parents realized intellectually more than 1 month in advance that the child would die (versus 12% who did not), 28.7% for parents who sensed that the child was aware of his or her imminent death (versus 7.8% who did not sense this) and 21.9% for those who received information that the child’s illness was incurable (versus 9.4% who did not receive the information). Prevalence of children’s unrelieved pain was 11.6% for those receiving home care and 15.3% for those receiving care outside the home.

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Sex Differences in Home Care Performance: A Population-Based Study

Women s Health Issues ◽

10.1016/j.whi.2015.01.004 ◽

2015 ◽

Vol 25 (3) ◽

pp. 232-238 ◽

Cited By ~ 4

Author(s):

Amanda T. Lo ◽

Andrea Gruneir ◽

Susan E. Bronskill ◽

Arlene S. Bierman

Keyword(s):

Sex Differences ◽

Home Care ◽

Population Based ◽

Population Based Study ◽

Care Performance

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Risk of Injury to Children Less Than 5 Years of Age in Day Care Versus Home Care Settings

PEDIATRICS ◽

10.1542/peds.84.6.1011 ◽

1989 ◽

Vol 84 (6) ◽

pp. 1011-1016

Author(s):

Frederick P. Rivara ◽

Carolyn DiGuiseppi ◽

Robert S. Thompson ◽

Ned Calonge

Keyword(s):

Home Care ◽

Home Environment ◽

Day Care ◽

Population Based ◽

Population Based Study ◽

Risk Of Injury

Recent studies have suggested that day care may be a relatively unsafe environment. In this population-based study, the incidence of injuries in day care and home care were evaluated based on the number of hours children were exposed to each environment. In this population, 43.6% of children less than 5 years of age spent part of the year in day care. The rate of injuries in day care was 2.50 per 100 000 child-hours of exposure compared with a rate of 4.88 per 100 000 child-hours of exposure in the home environment. There were no differences in overall severity of injuries in the two groups. It was concluded that children are at no greater risk of injury in day-care settings than in the home environment.

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