Study on admittance and exit criteria of palliative care in community

Objective To build the admittance and exit criteria of palliative care in community, so that to guide the communities to screen people who really belong to the area of peace care and need the palliative care most. Methods Through the literature review and focus group interviews, it got the dimensions of the admittance and exit criteria for palliative care in community. Deeply, executive and managerial representatives from six pilot units of palliative care in Shanghai were invited to participate in the two rounds of Delphi consultation, which was designed to collect the opinion on the admittance and exit criteria for palliative care in community from them. Results The four dimensions of admittance criteria for palliative care in community were disease, survival, symptom, subjective intention of patients and their families. The three dimensions of exit criteria were subjective intention of patients and their families, symptom and the death of patients. Compared with the admittance criteria for palliative care at home, the palliative care in institutions showed the difference in the admittance criteria of disease, survival, and symptom. In terms of access requirements for the disease, the palliative care in institutions allowed the cerebrovascular disease while the palliative care at home did not. In terms of survival, the palliative care in institutions tended to accept patients with a survival period of less than 90 days, while the palliative care at home tended to accept patients with a survival period of less than 180 days. Conclusion Compared with the original criteria, the admittance and exit criteria of palliative care in community in this study complements the other requirements of the survival time, defines the range of the disease, and takes into account the service capacity of the pilot units and the expression of the willingness of the client. What's more, it adds the exit criteria, which could lay the foundation for the orderly referral among the palliative care at home, the palliative care in institutions and general hospitals.