Reasons to Access the Emergency Department by Patients Who Receive Palliative Home Care: A Scoping Review
Bibliographic record
Abstract
BACKGROUND: The progressive aging of society has increased the prevalence of chronic, incurable diseases, creating a critical need for palliative care programs. Palliative home care services are essential for patients facing severe symptoms and barriers to accessing health care facilities. Despite this, many patients receiving palliative home care services still access emergency departments (EDs). OBJECTIVES: This scoping review aimed to investigate ED visits among patients under palliative home care services, examining factors influencing access, patient characteristics, and leading reasons for ED visits. METHODS: A scoping review was conducted by performing a systematic search of Scopus, PubMed, CINAHL, and PsycINFO between 2013 and 2024. Studies focusing on emergency access among adult patients older than 18 years cared for by a palliative home care service were included. RESULTS: Eight retrospective studies across Italy, China, Canada, Australia, and Ireland were included. The studies revealed significant variability in ED visit rates, ranging from 8.6% to 69.15%, with cancer as the predominant diagnosis among patients. Dyspnea, pain, and fever were commonly cited reasons for ED visits, indicating potential gaps in symptom management at home. DISCUSSION: The review highlights the importance of early enrollment in palliative home care services, multidisciplinary care, and better caregiver education to reduce unnecessary ED visits. The findings underscore the need for further research on predictive factors, avoidable versus unavoidable ED visits, and strategies for optimizing home-based palliative care to enhance patient outcomes and quality of life.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.044 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.005 |
| Bibliometrics | 0.012 | 0.013 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".