Social characteristics of Dutch hospice patients with varying lengths of stay.

Abstract

Abstract: Objectives: Although only patients with a life expectancy under three months have access to inpatient hospice care, a broad variation is seen in lengths of admission in Dutch hospices. In order to ensure a timely referral, interest should be taken in the complexity of a patient’s palliative care situation, i.e. considering patient specific, care team and social influencing factors. This study explores a range of characteristics within the social domain of hospice patients with varying lengths of stay. Methods: A retrospective chart review was performed. Medical charts of hospice patients with an estimated life expectancy of under three months, that had entered the hospice between January 2022 and November 2024 and died or left the hospice before November 2024, were screened for social characteristics documented within the first two weeks of admission. Results: Data from the 91 reviewed medical charts showed a slightly female population (55%), either living together with a partner (46%) or being widowed (32%). Most main diagnosis were oncological (76%), with cardiovascular diseases present in over 50% of all subgroups. Life expectancy was mainly estimated at one to three months (60%) or unknown (17%). Descriptive analysis showed differences in admission and social characteristics between groups with varying lengths of stay. Significant intergroup differences were found regarding the involvement of informal caregivers, i.e. short (75%) versus middle (41%) group of length of stay, and the initiative for admission by the patient, i.e. middle (61%) versus short (25%) and long (31%) length of stay. For a large proportion of the remaining social and admission variables numbers were insufficient to test significance. Conclusion: The data in this study suggest variation is found in variables within the social domain of Dutch hospice patients, which influence complexity of the palliative care situation and might be reflected in different lengths of admission. Healthcare providers should be aware of this possible influence when considering hospice admissions. However, social information is often unknown on admission, indicating the need for standardized Dutch palliative assessments on admission.