The prevalence of life-limiting illness at a Ugandan National Referral Hospital: a 1-day census of all admitted patients

The prevalence of life-limiting illness at a Ugandan National Referral Hospital: a 1-day census of all admitted patients

Jacinto A; Masembe V; Tumwesigye Nazarius Mbona; Harding R

Bmj Supportive & Palliative Care

2014

BACKGROUND: Although models of hospital-based palliative care are common in high-income countries, they are rare in low-income countries despite the high burden of progressive disease. AIM: To measure the proportion of all adult and child patients admitted with previously diagnosed active life-limiting disease, who therefore may be appropriate for palliative care provision, across all beds. DESIGN: One-day 24 h census using chart review across every ward and department. SETTING/PARTICIPANTS: All admitted patients at a large tertiary referral hospital in sub-Saharan Africa. RESULTS: Of 1763 reviewed patients, 663 (37.7%) had a diagnosed active life-limiting disease. Of these, 130 (19.6%) were children. The most prevalent diagnoses were HIV (41.7%), cancer (41.5%) and heart disease (9.2%). During the 24 h census period 19 patients died (population mortality rate 0.01%). CONCLUSIONS: In order to appropriately respond to need, hospital-based palliative care services in low-income settings must be of adequate size to respond to high prevalence of life-limiting illness, and to provide education and support to clinical colleagues managing all patients with life-limiting disease.

2014-11

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