PALLIATIVE CARE: THE REFLECTION OF THE LACK OF SUPPORT BEDS IN THE OCCUPATION OF TERTIARY BEDS IN AN ONCOLOGICAL HOSPITAL IN SÃO PAULO/BRAZIL

Introduction: The importance of palliative care covers both the psychosocial aspects and the adequate control of symptoms of those with advanced disease. In the final phase of life, many patients require institutional support. The support beds / long-stay units in services of low complexity can promote the necessary care and decrease the occupation in tertiary beds. Objective: To evaluate the percentage of patients in palliative care who were able to transfer to the support-beds and the reflection of the absence of these beds in the occupation of tertiary beds by patients in palliative care who evolved to death during hospitalization. Method: This work was carried out with information contained in the medical records in conjunction with the registry of patients in palliative care in a Clinical Oncology ward started in 2015. Data were collected from all patients who were attended by the team in the period of 05/01/2015 to 12/31/2016. Results: 509 patients were evaluated by the Palliative Care team in the Clinical Oncology ward between 05/2015 and 12/2016. Of the total number of patients evaluated, 78% of the patients belonged to the SUS, 72.7% died in the hospital and only 2 patients (0.4%) were able to transfer to longstay beds. For patients who evolved to death, the mean time of hospitalization was 13.1 days with a standard deviation of 12.5 days. The average occupancy rate for patients who died was 8.4 beds. In the months of most occupation, up to 17 beds were used by patients in palliative care who died. Conclusion: The absence of hospice care has already been demonstrated in a phase III study conducted by Temel et al as an inadequate condition at the end of life. The factors most associated with death in a hospital environment are the absence of a caregiver, limitations of the caregiver due to health problems, single caregiver of old age, presence of more than one member of the community living in need of care, structural limitations or sanitary conditions of the home. Currently, in our country, there are only 177 palliative care services registered in the National Academy of Palliative Care, with 74% working in hospitals and only 5% in hospice. The study showed that only 0.4% of the patients in palliative care at an oncology hospital were able to transfer to the support beds, and in the months of most occupation, up to 17 beds were occupied with this patient profile.