Clinical and health care setting of patients admitted at Pain Control Center Hospice of Solofra: A feasibility model of end-of-life care in the Avellino province of Italy.

59 Background: The Pain Control Center Hospice of Solofra (Italy) is managed with a mixed public / private, the first experience in the Campania region.We have evaluated the treatment procedures and the clinical outcome to make a comparison by between 123 evaluable patients in palliative care in 2015 and 232 evaluable patients in the biennium 2012-2014.

METHODS: The following characteristics: patient gender, mean hospitalization time, differentiation between cancer and non cancer patients, medical weapon use, venous access type, enteral and parenteral feeding, pain killer use,Karnofsky scale.

RESULTS: the average age is nearly overlapping being 70.5 yr vs 70.69 yr; average length of stay in hospice 24.33 days vs. 27.52 days; 79.67% had cancer vs 73.70%, while the non-cancer 20.32% vs 26.30%; 55.26% died in hospice vs 71.98%, while 44.7% were discharged home vs 24.56%; the performance status according to Karnofsky scale before admission to hospice 23.1% had index rating (%)- 50, 10.56 -40, 52.03%-30, 35.7%-20, 23.1%-10. 8.9% had ostomy vs 13.79%; 4.4% were carriers of PEG vs 6.3%; the central venous access already implanted at admission in 32.52% vs 26.72%; enteral feeding was administered in 23.7% vs 13.79% and parenteral feeding in 52.84% vs 46.98%; analgesic therapy with more opiates was already present on admission in 48.78% vs 40.94% with prevalence of trans TD formulations. Analgesic therapy was administered during the hospitalization in 66.66% vs 81.89%. 14.28% of cancer patients in 2015 have received morphine treatment vs 15.3%, 22.11% oxycodone / naloxone vs 19%, 58.16% trans-dermal fentanyl vs. 34%, 14.7% have supplements onset fentanyl, 2.4% with tapentadol vs na, 15.30% tramadol vs 9%, 4.2% codeine vs 15.3%.

CONCLUSIONS: This report is a feasibility model of end of life-care in the Avellino province submitted to the public administrative control with the private organization supporting House Hospital Onlus. The present study shows gradual improvement of the knowledge of palliative care by the family doctors and the population of a territory with peculiar topography and induces public health authority to improve the care offered.