Home-Based Palliative Care for Patients With Non-Cancer Diagnoses: Clinical Characteristics,Symptom Burden,and Service Delivery

Abstract

Introduction

Population aging has contributed to the increased prevalence of chronic non-communicable and disabling diseases, increasing the demand for home-based palliative care.

Objective

To describe the sociodemographic, clinical, and care profile of patients with non-cancer treated by a Home Care Service in Palliative Care (SAD-CP) of the Unified Health System, who died within 10 years.

Methods

This is a cross-sectional study based on the analysis of medical records of non-oncology patients treated by a SAD-CP in Brazil. Sociodemographic, clinical, functional, and service-use-related variables were collected. Variables were used in absolute and relative frequencies, and medians and interquartile ranges. Survival analysis included the Kaplan-Meier curve.

Results

Among the 248 patients included, the main referral reasons to SAD-CP were neurological (25.4%) and circulatory (21.7%). The mean age was 80.8 years, with most patients being female (50.8%). At admission, 45.5% had a PPS score ≤30. The median length of stay was 50 days. Care was marked by frequent visits, with medians of 1.74 regular (scheduled), 1.25 nursing, 0.49 medical, and 0.18 emergency (unplanned) visits per day. All patients died at home, with deaths distributed evenly throughout the day.

Conclusion

Patients with non-cancer conditions admitted to SAD-CP care often present with a high burden of comorbidities and marked functional impairment. The association between lower PPS scores and higher service intensity highlights the need to adapt care to functional status and prognosis. With multidisciplinary support, home death can be successfully achieved. These findings underscore the urgency of strengthening public policies and expanding palliative care services.