Factors associated with XXXX care.

@entity1 @entity146 @entity5 @entity2 @entity2613 @entity158 @entity204
BACKGROUND: Many @entity1 with @entity5 experience @entity146 care towards the end of life (EOL) despite evidence of an association with poor outcomes such as @entity158 and overall dissatisfaction with care. PURPOSE: To investigate socio-demographic, clinical and community health care service factors associated with @entity5 care. METHODS: An analysis of pooled data from two mortality follow-back surveys was performed. Aggressive EOL care was defined as greater than or equal to one of the following indicators occurring during the last 3  months of life: greater than or equal to two emergency department visits, >= 30  days in hospital and @entity204 in hospital. RESULTS: Of the 681 included @entity1 , 50.1  % were @entity1 and mean age at @entity204 was 75  years. The majority of @entity1 (59.3 %,  95  % confidence interval (CI) 55.6-63.0  %) experienced at least one indicator of @entity146 EOL care: 29.7  % experienced greater than or equal to two @entity2613 visits, 17.1  % spent >= 30  days in hospital and 37.9  % died in hospital. @entity1 with prostate or haematological @entity5 were more likely to experience @entity146 EOL care (adjusted odds ratio (AOR) 4.36, 95  % CI 1.39-13.70, and 4.16, 95  % CI 1.38-12.47, respectively, reference group @entity2 ). @entity1 who received greater than five general practitioner (GP) home visits (AOR 0.37, 95  % CI 0.17-0.82, reference group no GP visits) or had contact with district nursing (AOR 0.48, 95  % CI 0.28-0.83, reference group no contact) or contact with community palliative care services (AOR 0.27, 95  % CI 0.15-0.49, reference group no contact) were less likely to experience @entity146 EOL care. No association was found between @entity146 EOL care and @entity1 ' age, gender, marital, financial or health status. CONCLUSIONS: Community health care services, in particular contact with community palliative care, are associated with a significant reduction in the odds of @entity5 @entity1 receiving @entity146 EOL care. Expansion of such services may help address the current capacity crises faced by many acute health care systems.
