Consultation of patients in palliativecare service for 1 year

Aim: The aim of this study was to renew and reorganize physicians' training schedules according to any consultation required by a physician in Palliative Care Service. For this purpose, the different reasons for consulting a physician were thoroughly analyzed. Additionally, patients' profiles have been examined to inform about palliative care inpatient. Material and Method: Data from the T.C Ministry of Health, Izmir Tepecik Training and Research Hospital between 01 September 2016 and 31 August 2017 in palliative care service inpatients data were obtained. The records were made using a based on a form that included the following parameters: patient age, sex, diagnosis, inpatient period, result type consultations amount, consulted department, consultation reason (diagnosis support and treatment recommendation, referral, preoperative appraisal, nursing home other social services). Data was expressed as percent, means ± standard deviation (SD). Comparisons between groups; categorical variables were performed with chi-square test, continuous variables were performed for parametric conditions with T Test, non-parametric conditions were performed with Mann-Whitney-U-Test. A value of P < 0.05 was considered statistically significant. Statistical analysis was performed with a SPSS Version 23.0 statistical software package. Findings: In total, 216 men and 115 women participated in this study. The average age of the men was 62,42±12,9 years, the average age of the women was 63,89±17,43 years. Therefore, the total average age was 62,93±14,63 years. The average length of inpatient stays was 19,17±16,34 days. 249 (75.2 %) patients were discharged, 34 (10.3 %) patients were referred to a different hospital/clinic/institution and 48 (14.5 %) patients died. When patients admissions diagnosis were examined, it came out that 131 (39.6 %) patients suffered from lung cancer. The review of the number of consultations revealed that 66 (19.9%) patients did not require any consultation at all, 40 (12.1%) patients only had one consultation, 47 (14.2%) patients had two consultations. The maximum number of consultations was 50.The total amount of consultations was 1,817 and the average of consultations for a patient was about 5,48±7,29.In 1533 (84.3%) cases, the reasons for consultation were for diagnostic and treatment purposes and in 199 (6.54%)cases for preoperative interviews. In 83 (4.56%) cases, the consultation was for the transfer and in 82 cases for the transfer to either a nursing home or another social service 82(4.51%). According to requested consultations in palliative care, consultations were mostly due to infectious diseases 357 (%19.64).It is clear to see that according to branches the reasons for consultation were mostly due to infection disease purposes of diagnostic and treatment, for referral 45 (54.21%) and preoperative evaluation purposes from anesthesiology and reanimation department, and to transfer patients from nursing homes and other social purposes from social service department. There was no significant difference between men and women due to the amount of consultations (p=0.275). However, there was a significant difference (p= 0.016) (p=0.014) between surgical and internal medicine branches due to consultation request reasons. In contrast, there was no statistically significant difference between a preoperative evaluation and a consultation for a transfer to a nursing home or other social services (p= 0.193) (p= 0.429). Result: Due to increasing life expectancy, age-related illnesses, chronic diseases and/or malignancy diseases are increasing. Hardly surprising, therefore, that the number of palliative care units is also increasing. Therefore, the training of physicians, who work in palliative care service, is crucial. This is also recognizable by the huge number of consultations. Particularly the training for infection disease department is essential. Key words: Consultation, Palliative Care, Family Doctor, Elderliness