Implementation Models of CompassionateCommunities and Compassionate Cities at the End ofLife: A Systematic Review

In the last decade, we have seen a growth of Compassionate Communities and Cities (CCC)at the end of life. There has been an evolution of organizations that help construct Community-BasedPalliative Care programs. The objective is to analyze the implementation, methodology andeffectiveness of the CCC models at the end of life. We conducted a systematic review followingPRISMA ScR Guideline. The protocol was registered on PROSPERO (CRD42017068501). Five databases(MEDLINE, EMBASE, Web of Science, CINAHL and Google Scholar) were searched for studies (from2000 to 2018) using set eligibility criteria. Three reviewers screened full-texts articles and extractedstudy data. Outcomes were filled in a registration form which included a narrative synthesis of eacharticle. We screened 1975 records. We retrieved 112 articles and included 31 articles for the finalanalysis: 17 descriptive studies, 4 interventions studies, 4 reviews and 6 qualitative studies. A total of11 studies regard the development models of CCC at the end of life, 15 studies were about evaluationof compassionate communities’ programs and 5 studies were about protocols for the development ofCCC programs. There is poor evidence of the implementation and evaluation models of CCC at theend of life. There is little and low-/very low-quality evidence about CCC development and assessmentmodels. We found no data published on care intervention in advance disease and end of life. A globalmodel for the development and evaluation of CCC at the end of life seems to be necessay

Las tecnologías de la información y comunicación en salud mental (Telepsiquiatría)

Este documento se ha realizado en el marco de colaboración previsto en el Plan de Calidad para el Sistema Nacional de Salud, al amparo del convenio de colaboración suscrito por el Instituto de Salud Carlos III, organismo autónomo del Ministerio de Sanidad y Consumo, la Agencia de Evaluación de Tecnologías Sanitarias del Instituto de Salud Carlos III y la Fundación Canaria de Investigación y Salud “FUNCIS”Objetivos: Conocer si existe información y, en su caso, el grado de validez científica, sobre la efectividad y eficiencia de la atención psiquiátrica al paciente utilizando las tecnologías de la información y comunicación (TIC)

Health care services utilization and cost in the last year of life in Colombia: a retrospective study

Introduction: Health care costs at the end of life cause a high expenditure on health care resources. Theimplementation of integrated palliative care programs has proven to be cost-efficient. The study aimedto analyze the consumption and cost of health care resources during the last year of life of patients whoare not part of a palliative care program.Methods: A descriptive, longitudinal and retrospective study was conducted in patients of a Colombian healthinsurance company who died in 2013 due to pathologies that were susceptible and non-susceptibleto palliative care. Causes of death were obtained from official death certificates. McNamara et al. strategyof classification was applied and adapted to assess services received during the last year of life. Analysisof costs was conducted by pathologies at different levels of care.Results: 3,392 deaths in 2013 (70% susceptible to palliative care and 30% non-susceptible to palliativecare). Total health care cost: USD 47,550,155. Patients susceptible to palliative care were responsible for84% of the year’s expenditure (the annual expenditure) (USD 40 million). There were significant differencesbetween the average costs for susceptible and non-susceptible palliative care patients (USD 16,878 versusUSD 7,433 per year, p < 0.001). The average cost per patient for the last three months of life represented52% of the expenditure during the last year of life (USD 8,754). The last month of life was 25.6% of theexpenditure during the last year of life (USD 4,324).Conclusions: Cost of care for the last three months of life of susceptible palliative care patients generatesa huge health care expenditure, mainly attributable to hospital care cost. The implementation of a palliativecare program could decrease these assistance costs