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Emergency Medicine InternationalVolume 2012 2012, Article ID 486516, 11 pages

Review Article

Simpson Centre for Health Services Research, South Western Sydney Clinical School Liverpool Hospital and The Australian Institute of Health Innovation AIHI, University of New South Wales, Level 1, AGSM Building G27, Kensington Campus, Gate 11, Botany Street, Randwick, NSW 2052, Australia

Centre for Health Informatics, The Australian Institute of Health Innovation AIHI, University of New South Wales, Level 1, AGSM Building G27, Kensington Campus, Gate 11, Botany Street, Randwick, NSW 2052, Australia

Emergency Care Institute, NSW Agency for Clinical Innovation, Tower A, Level 15, Zenith Centre, 821-843 Pacific Highway, Chatswood, NSW 2067, Australia

Australasian College for Emergency Medicine, 34 Jeffcott Street, West Melbourne, VIC 3003, Australia

Clinical Excellence Commission of New South Wales, Locked Bag A4062, Sydney South, NSW 1235, Australia

School of Public Health and Community Medicine, University of New South Wales, Level 3, Samuels Building, Randwick, NSW 2052, Australia

Aged Care Research Unit, South Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Level 2, 2-4 Speed Street, Liverpool, NSW 2170, Australia

Palliative Care Services, Illawarra Shoalhaven Local Health District, David Berry Hospital, 85 Tannery Road, Berry, NSW 2535, Australia

Centre for Clinical Governance Research in Health, Australian Institute of Health Innovation AIHI, University of New South Wales, Level 1, AGSM Building G27, Kensington Campus, Gate 11, Botany Street, Randwick, NSW 2052, Australia

Intensive Care Department, Liverpool Hospital, Liverpool, NSW 2170, Australia

Received 8 September 2011; Revised 21 November 2011; Accepted 13 December 2011

Academic Editor: Jeffrey R. Avner

Copyright © 2012 Roberto Forero et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The hospitalisation and management of patients at the end-of-life by emergency medical services is presenting a challenge to our society as the majority of people approaching death explicitly state that they want to die at home and the transition from acute care to palliation is difficult. In addition, the escalating costs of providing care at the end-of-life in acute hospitals are unsustainable. Hospitals in general and emergency departments in particular cannot always provide the best care for patients approaching end-of-life. The main objectives of this paper are to review the existing literature in order to assess the evidence for managing patients dying in the emergency department, and to identify areas of improvement such as supporting different models of care and evaluating those models with health services research. The paper identified six main areas where there is lack of research and-or suboptimal policy implementation. These include uncertainty of treatment in the emergency department; quality of life issues, costs, ethical and social issues, interaction between ED and other health services, and strategies for out of hospital care. The paper concludes with some areas for policy development and future research.





Autor: Roberto Forero, Geoff McDonnell, Blanca Gallego, Sally McCarthy, Mohammed Mohsin, Chris Shanley, Frank Formby, and Ken Hill

Fuente: https://www.hindawi.com/



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